Expanding psychiatric service in a hospital emergency room

Senior medical residents were used to extend psychiatric coverage in a busy hospital emergency room. Their service was supported by the backup consultation of senior psychiatric physicians. The medical residents worked in conjunction with psychiatric residents to provide 24-hour daily emergency psychiatric service to more than 350 patients during a 12-month period. There were no significant differences in the demographic composition of the patient population seen or in the disposition of individual patients made between the medical and psychiatric residents. The hospital was able to expand its psychiatric service in the emergency room without major increases in cost. The medical residents benefited by experiencing a more diversified patient care training program, and they earned a modest supplement to their houser officer salary.