Determination of financial competence in consultation-liaison psychiatry

The aging of our population will require physicians to become more aware of the issues surrounding the determination of financial competence. This retrospective study involved the review of 46 medical or surgical patients in a university teaching hospital that were referred to the psychiatric consultation-liaison team for assessment of financial competency. Charts were reviewed for completeness of documentation using suggested criteria for determination of financial competence. The study found that while many criteria were frequently documented, documentation was incomplete for important criteria, such as calculating abilities, judgement, the patient's appreciation of the consequences of financial competence, presence of delusions with regard to finances and the patient's awareness of debt. Concerns are expressed regarding a physician's ability to recall details pertaining to cases before a tribunal without complete and careful documentation. The importance of establishing formal criteria for the determination of financial competence is also discussed.