Psychosomatic clinic or pain clinic. Which is more viable?

Outpatient consultation-liaison (C-L) psychiatry has been beset with problems concerning funding and patient acceptance. Though the consultation, liaison, and referral clinic models for outpatient C-L psychiatry each offer advantages, they have not conquered these fundamental problems. This paper introduces the multidisciplinary pain clinic as an alternative means of addressing somatic symptoms and psychiatric disorders in an ambulatory medical population. The multidisciplinary pain clinic offers advantages in terms of reimbursement, patient acceptance, and opportunities for interdisciplinary research. The pain clinic model has disadvantages that include administration by departments other than psychiatry, traditional location in a tertiary care hospital, and limitations to who can be treated. However, it offers a place where both the physiological and psychological aspects of somatic symptoms may be addressed. The pain clinic nurtures the priorities and goals of primary care for a patient population whose complexities may outstrip the resources of a single primary care physician.