Liaison psychiatry-otolaryngology rounds

In an attempt to define and resolve patient and staff needs with regard to the psychological, social and economic problems in clinical otolaryngology, psychiatry/otolaryngology rounds were established in the Department of Otolaryngology 18 months ago. These weekly rounds have contributed greatly to improved patient care and better physician-nurse relations. They have also served a significant educational role for residents, medical students and other members of the patient care team. At present the rounds are attended by the inpatient nursing staff, 2 physicians, 6 residents, 3 medical students, an otolaryngologic social worker and the liaison psychiatrist. The meeting begins with a 10 minute discussion and review of current problems among the staff. Attention is then directed to the patient who will be interviewed for the day. The medical and social history are presented. Then the patient is brought in and interviewed in a non-stressful session for 20 minutes. After the patient leaves, the staff discusses the problems which the patient has encountered or poses to them, and the conference participants formulate an appropriate therapeutic plan. Among the problems which have been discussed are noncompliance, organic mental syndromes, hypochondirasis, depression, death and dying, disfigurement, loss of bodily function, and chronic pain. For those patients in whom further psychiatric evaluation and treatment are deemed necessary, the psychiatrist becomes an active participant in their clinical care.