Referrals and Reciprocity: Psychiatrists, General Practitioners, and Clergymen

Both clergymen and general practitioners are much more frequently initially consulted by persons with emotional problems than psychiatrists, the supposed treatment source. Despite their preference not to deal with mental disorders, however, neither of them make frequent referrals to mental specialists. An explanation for this paradox was sought in terms of psychiatrists infrequently reporting to the referring clergyman or GP about persons referred. Questionnaire data from a sample of metropolitan clergymen and GPs showed that reports and referrals were directly associated for clergymen; a curvilinear relationship obtained for GPs. Besides pragmatic utility, these findings have theoretical implications for studying reciprocity in a system of functionally autonomous parts engaged in unequal exchanges.