A survey of patients shows that primary care physicians aren't paying nearly as much attention to mental health as they should be. 

The poll of 44,000 patients in Massachusetts suggests that many had not been asked about depression by their doctors. 

Patients were asked to rate the performance of their doctor on certain measures on a scale of 1-100. While patients generally gave their physicians good grades, they assigned them middling marks on issues of behavioral health and self-management.

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The median score physicians received for general communication was 93.5. The typical doctor also received a score of 88.9 for his or her general medical knowledge. 

But on behavioral health, the median score was only 55.6. Those figures for 2015 represent a slight improvement over 2014, when the median score for behavioral health was 53.1. 

On self-management, a category added to the annual survey for the first time in 2015, the median physician earned a score of 54.7. 

"Depression and substance abuse are often overlooked in primary care visits,'' Barbra Rabson, president of Mass. Health Quality Partners, the nonprofit that conducts the survey, told the Boston Globe. "Physicians are not as comfortable screening for it. And patients can be really uncomfortable talking about it.'' 

The survey is part of an ongoing attempt to put more emphasis on mental health in the U.S. health care system. That has been accompanied by provisions in the Patient Protection and Affordable Care Act that demand insurance plans provide "parity" for mental health services.

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