TY - JOUR
T1 - Consultation-liaison psychiatry. Possibilities for the 1990s
AU - Strain, James J.
AU - Gise, Leslie H.
AU - Fulop, George
N1 - Funding Information:
Attending psychiatrists are supported by grants from several sources: The Sexual Dysfunction Clinic (one third-line), Department of Medicine Educational Grant (one half-line for 5 years, one quarter-line currently), National Institute of Mental Health (“Cost Offset of a Psychiatric Intervention with Elderly Hip Fracture Patients,” in collaboration with the Department of Orthopedics (one half-
Funding Information:
By utilizing attendings to deliver psychiatric consultations these physicians are able to bill for services rendered. For example, all patients in the hemodialysis/renal transplant program are evaluated by a psychiatrist and offered treatment as indicated. As the majority of these patients are on Medicare, funds generated support a half-time psychiatrist [lo]. Similarly, because of the high prevalence of psychiatric comorbidity among geriatric inpatients, they are all screened and (if necessary) treated on the inpatient service Department of Geriatrics. As the majority have Medicare, a full-time attending is funded. The Department of Geriatrics provides a separate teaching supplement [ll]. One half-line is supported by the Department of Neoplastic Diseases and AIDS-related work. The orthopedic department funds a one quarter-line for an attending psychiatrist to screen all elderly patients admitted for hip fracture. The modal reimbursed fee for psychiatric service is $80 for each patient visit [12]. An otolaryngology department annual stipend provides the majority of one half-line for an attending to screen head and neck patients and conduct weekly ENT-psychiatry rounds [ 11,131. The remainder of this half-line comes from the same attending coordinating the psychiatric consultation service and his or her direct evaluation and treatment of consultation patients with the psychiatric resident observing.
PY - 1989/7
Y1 - 1989/7
N2 - In order for consultation-liaison ( C L) psychiatry to enhance its acceptance and funding, carefully designed outcome studies that will demonstrate its clinical effectiveness to other disciplines in medicine, departments of psychiatry, hospital administration, third-party payors, and patients are required. The development of alternative methods of funding C L services is described: (1) high-risk screening, renal transplant, geriatric units (Medicare); (2) salary stipends from collaborating disciplines, e.g., medicine, ENT, neoplastics; (3) consultation fees; (4) ambulatory C L clinics (Medicaid); and (5) grants from collaborative research. With a change in structure when it can be employed (from consultation to the screen methodology), the development of scientifically derived outcome data of C L psychiatry interventions, adequate documentation of the evaluation and treatment by C L psychiatry, and the new tools biological psychiatry and psychopharmacology will provide, the 1990s could and should be an exciting time for this subspecialty of psychiatry.
AB - In order for consultation-liaison ( C L) psychiatry to enhance its acceptance and funding, carefully designed outcome studies that will demonstrate its clinical effectiveness to other disciplines in medicine, departments of psychiatry, hospital administration, third-party payors, and patients are required. The development of alternative methods of funding C L services is described: (1) high-risk screening, renal transplant, geriatric units (Medicare); (2) salary stipends from collaborating disciplines, e.g., medicine, ENT, neoplastics; (3) consultation fees; (4) ambulatory C L clinics (Medicaid); and (5) grants from collaborative research. With a change in structure when it can be employed (from consultation to the screen methodology), the development of scientifically derived outcome data of C L psychiatry interventions, adequate documentation of the evaluation and treatment by C L psychiatry, and the new tools biological psychiatry and psychopharmacology will provide, the 1990s could and should be an exciting time for this subspecialty of psychiatry.
UR - https://www.scopus.com/pages/publications/0024385733
U2 - 10.1016/0163-8343(89)90068-6
DO - 10.1016/0163-8343(89)90068-6
M3 - Article
C2 - 2744426
AN - SCOPUS:0024385733
SN - 0163-8343
VL - 11
SP - 235
EP - 240
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 4
ER -