The American Academy of Family Physicians recently noted that more and more often, trusted family physicians are the ones that patients are turning to for initial mental health treatment. And for many patients, that’s just how it should be.

Mind Over Matter

What’s the first thing you think of when you think of health?

Diet and exercise? Regular checkups? Preventative care like wearing sunscreen or being tested for common disorders?

Sure, all those things factor heavily into your health. But for too many people, the conversation does not revolve enough around another area: mental health. Believe it or not, there is a substantial link between your mental health and your physical health, and if things aren’t quite right mentally, even a robust body can be brought to a total standstill.

For various reasons, there has long been a stigma in our society surrounding mental health and the extent to which we acknowledge how much it can affect us. Our culture bombards us with messages about how we are supposed to be resilient, able to weather social pressures and other stressors that life throws our way. Yet, it’s not always that simple to shrug off the mental challenges we face, and many people find themselves feeling like they are fighting a losing battle to try and stay “above water,” as it were, in the struggle to hold onto their mental health.

Family Physicians & Personal Connection

If the stigma of seeing a therapist or counselor is too much for a person to bear, the alternative has traditionally been a white-knuckle, “grit it out” approach. Certainly, there are things that an individual can do to help themselves overcome a bout of anxiety, neurosis, or depression, but the prognosis is much better if that person seeks guided treatment.

As it turns out, there is a third option for folks who need psychiatric help, and it’s one that is being utilized now more than ever: their general practitioner or primary care physician. It’s a phenomenon that has been so prevalent in the medical world that it has received a good deal of attention in medical journals and publications. It makes sense: a primary care physician is someone who has usually known you for years, someone who has proven themselves to be helpful and discreet, and someone who you associate with healing.

For those reasons, patients are turning to their primary care physicians in greater and greater numbers to unburden themselves of their minor to moderate mental health concerns. And as it turns out, those physicians are doing an admirable job of advising and treating those patients, often without resorting to prescribing medication unnecessarily.

Dr. Momjian’s Take

Each week, Urgent 9 founder Dr. Manuel Momjian will personally weigh in on the topics covered by the blog.

Psychiatry is so very different than the rest of medicine. In medicine, you either have pneumonia, or you don’t. But in the abstraction of psychiatry, a little anxiety can be good for you.

Anxiety can help you wake up in the morning, so that you can get to work on time. Depression after a tragic breakup makes you stronger in your next relationship. In other words, the lines are blurred between when someone is sick or completely normal.

Opening a patient’s eyes to the possibility of anxiety being the cause of chronic dizziness can be a challenge in itself. But, no other provider is as well equipped as a primary care provider to tackle this monstrous task and to do it with finesse.
 
I believe that primary care providers can, and should, take care of the majority of minor psychiatric problems. But there is an intrinsic risk with the gatekeepers in medicine becoming too comfortable with powerful psychiatric medications.

I am a firm believer in a “less is more” approach to medicine and keeping a distinct separation between primary care and specialty medicine. I think that primary care doctors should be prescribing strong psychatric medications as often as they prescribe powerful chemotheraputics — which is basically as little as possible. Let an oncologist treat cancer, and a psychatrist treat psychosis, because we have to draw the line somewhere.

— Dr. Momjian