Psychiatrists Are also Physicians-Reply

In Reply.  — Dr Liptzin does not agree that "psychiatric training should emphasize the medical aspects of psychiatry to prepare psychiatrists to be primary-care physicians." We, however, never suggested that psychiatrists should be "primary-care physicians" in the sense of providing all the functions of a general practitioner or internist. Rather, we specifically noted that in referring patients of lower socioeconomic class who do not have a private physician, our hospital-based colleagues often regard the psychiatrist as a primary-care physician; that is, they do not examine these patients fully prior to referring them. We question, however, whether any patient consulting us should expect medical ignorance. Both our study and others'^1-2 suggest that most psychiatric patients with physical illnesses that exacerbate or produce psychiatric symptoms are unaware of the underlying condition.In our study, detailed physical examinations were performed by both internists and psychiatrists; both did well in demonstrating physical signs that would lead to appropriate medical workup. McIntyre and Romano³ also