Measuring outcomes in patients with depression or anxiety: an essential part of clinical practice

To the Editor: As a general practitioner I was gratified to see Dinnen's letter1 in which he questioned the "urgent need" for GPs to use more questionnaires for depression management. Reading the professorial reply,2 I despair. As more and more specific health promotions are introduced (eg, Asthma 3-Step Plans, Diabetic Care protocols, Health Assessments, Care Plans) we have to consider not just our patient's problems, but which forms to fill out or numbers to put down to fulfil Health Insurance Commission requirements or be correctly remunerated.

By the time a depressed patient is sitting in my room, he or she wants to be correctly diagnosed and treated, not to be given a form to fill out. In my opinion, to hand a form to a depressed patient who has tearfully told me his or her problems is an insult. We do not (yet) expect patients to fill out a checklist for heart failure. As to the suggestion that the form be filled out in the waiting room, how is this to be done? Should the patient be sent out again with form in hand? Privacy concerns do not allow reception staff to hand out such forms, and the waiting room is not the best place to fill them out if they are needed. In reality, the GP is likely to give the patient a form and then go have a coffee or make a telephone call.

No psychiatrist will ever receive a referral from me based on a K10 score. I may, however, mention that my patient still has suicidal impulses, cries a lot, has trouble sleeping and cannot concentrate at work. That should be easy enough for anyone to understand.