title: Psychiatric consultation in a medical clinic: what do medical providers want?
abstract: A participant observation needs assessment of the use of a psychiatrist in a primary care medical setting was undertaken to quantify details of the interaction between a psychiatrist and primary care providers. Two hundred seventeen encounters involving 63 providers were recorded over a five and one-half month period. Utilization of the psychiatrist was widespread but skewed, with only 17% of the sample using 50% of the services. The mean number of encounters for all providers was 3.44. Consultation occurred mainly in a private area of the clinic, usually in an unplanned fashion. Only 21% of encounters involved seeing a patient. The range and content of these interactions was broad. Initial reasons for consultation were often redefined as the consultation ensued. The kinds of help most frequently requested involved discussing nonpsychopharmacologic treatments (35%), assisting providers with evaluations (31%), and exploring unresolved feelings about patients or patient care issues (29%). Slightly more than 50% of encounters required some type of follow-up. The findings suggest that psychiatrists who wish to work in primary care settings must have expertise in a multitude of areas and must be flexible in adapting themselves to the setting in which the primary care providers work.
mesh_terms: D003376:Counseling; D006801:Humans; D007400:Interprofessional Relations; D001523:Mental Disorders / Q000628:therapy; D010347:Patient Care Planning; D010348:Patient Care Team; D011320:Primary Health Care; D011570:Psychiatry; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012017:Referral and Consultation; D012803:Sick Role
chemical_list: D011619:Psychotropic Drugs