To the Editor.—I am writing in response to a recently published article in the ARCHIVES by McIntyre and Romano (34:1147-1151, 1977) that underscores the importance of considering a screening physical examination on all patients prior to the institution of psychiatric treatment, whether it is in the form of psychotherapy or chemotherapy. I would like to inform you of the experience we have had using this approach.
The Northwest Center, Philadelphia, is one of the few community mental health centers that requires a complete and comprehensive medical evaluation prior to the commencement of psychiatric treatment. Since April 1974, the center has made it mandatory that all new clients have a thorough medical evaluation; this includes a physical examination, complete blood cell count, serology, 24 factor automated blood chemistry analysis, urinalysis, chest roentgenogram, etc.
The choice of physician is made by the patient who may choose his/her own or use the