Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study.
BACKGROUND
The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients.


OBJECTIVE
The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services.


METHODS
Program directors of seven academic Psychosomatic Medicine (PM) programs in the Northeast were surveyed to establish current staffing patterns and patient volumes. Survey data were reviewed and analyzed along with data from the literature and The Academy of Psychosomatic Medicine (APM) fellowship directory.


RESULTS
Staffing patterns varied widely, both in terms of the number and disciplines of staff providing care for medical and surgical inpatients. The ratio of initial consultations performed per hospital bed varied from 1.6 to 4.6.


CONCLUSIONS
Although staffing patterns vary, below a minimum staffing level, there is likely to be significant human and financial cost. Efficient sizing of a PM staff must be accomplished in the context of a given institution's patient population, the experience of providers, the presence/absence and needs of trainees, and the financial constraints of the department and institution. National survey data are needed to provide benchmarks for both academic and nonacademic PM services.
Thomas Jefferson University, Dept. of Psychiatry and Human Behavior, 1020 Sansom St., Suite 1652, Philadelphia, PA 19107, USA. elisabeth.kunkel@jefferson.edu
Elisabeth J S
EJ
Kunkel
Elena
E
Del Busto
Roger
R
Kathol
Theodore A
TA
Stern
Thomas N
TN
Wise
Frederick R
FR
Stoddard
Joshua
J
Straus
Stephen M
SM
Saravay
Philip R
PR
Muskin
Nehama
N
Dresner
Colin J
CJ
Harrington
Joseph
J
Weiner
John
J
Barnhill
Madeleine
M
Becker
Robert C
RC
Joseph
Olugbenga
O
Oyesanmi
Jesse R
JR
Fann
Eduardo
E
Colon
Steven
S
Epstein
Robert
R
Weinrieb
D006769:Hospitals, General; D006801:Humans; D009511:New England; D010820:Physicians / Q000600:supply & distribution*; D010865:Pilot Projects; D011611:Psychosomatic Medicine; D011795:Surveys and Questionnaires; D000078329:Workforce