Psychiatric Consultation Services in the Large General Hospital: A Review and a New Report

Abstract

Studies are reviewed documenting increased interest in psychiatric consultation services in the general hospital, and disparities between the need for and the availability/utilization of consultation services are examined. The emergence of the eclectically trained psychiatrist as the most acceptable consultant in the general hospital is discussed. An exploratory attitudinal questionnaire, developed and circulated to a sample of attending physicians in a midwestern university teaching hospital, yielded the following data. Thirty-nine per cent (N = 96) of the 244 physicians who received the questionnaire responded. Ninety-nine per cent of the respondents agreed that readily available psychiatric consultation services should be fully operative in all large general hospitals; 88 per cent agreed that psychiatric consultations in the general hospital must be performed by a physician with special training in psychological medicine; 50 per cent indicated a preference for a biologically-oriented psychiatrist, and 26 per cent preferred a family practitioner or internist who had subsequently become a psychiatrist. The majority of respondents indicated that between July 1974 and July 1975, 1–5 per cent of their private hospitalized patients received inhospital psychiatric consultation. Eighty-six per cent of the respondents felt the patients should be billed directly at a rate equal to other medical/surgical consultations. These data are correlated with issues involved in the utilization of psychiatric consultation in the general hospital.