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A very modest proposal for 1990s C/L psychiatry
M F Weiner1, J Sadler, B J Fenton
1University of Texas Southwestern Medical Center, Department of Psychiatry, Dallas 75235-9070.
General Hospital Psychiatry
|July 1, 1989
Summary
Consultation-liaison psychiatry has not become integral in all hospitals due to funding issues. The authors propose a focused role in teaching hospitals for education and research.
Area of Science:
- Psychiatry
- Healthcare Management
Background:
- Consultation-liaison (C/L) psychiatry was predicted to be integral in managing medical/surgical patients.
- Adequate funding mechanisms for widespread C/L psychiatry have not been established.
- Current economic conditions make broad implementation less likely.
Purpose of the Study:
- To re-evaluate the role of consultation-liaison psychiatry in hospital settings.
- To propose a sustainable model for C/L psychiatry services.
- To identify key functions for C/L psychiatry within academic medical centers.
Main Methods:
- The study reviews the historical trajectory and economic viability of consultation-liaison psychiatry.
- It analyzes the successful implementation of C/L psychiatry in a large public teaching hospital over a decade.
- The authors consider the evolving healthcare landscape and funding challenges.
Main Results:
- The broad integration of C/L psychiatry into all hospitals has not materialized as predicted.
- A lack of sustainable funding is the primary barrier to widespread adoption.
- A reduced role focused on teaching hospitals is suggested as a viable alternative.
Conclusions:
- Consultation-liaison psychiatry's role may need to be redefined, focusing on academic medical centers.
- Key functions include medical student education, resident training, managing complex cases, and interdisciplinary research.
- This focused approach offers a sustainable model for C/L psychiatry within teaching hospital environments.