A very modest proposal for 1990s C/L psychiatry

The prediction that consultation-liaison psychiatry would play an integral role in the management of all medical/surgical patients in large hospitals has not come to pass. The primary reason is that no adequate funding mechanism has ever been found to support such a large endeavor. The economic climate as we enter the 1990s makes such funding even less likely. The authors suggest that C/L psychiatry accept a lesser role, largely confined to teaching hospitals. That role, which has been successful at a large public teaching hospital for nearly 10 years, encompasses serving as a primary psychiatric teaching site for medical students, a primary teaching site for psychiatry residents and other postgraduate physicians rotating through psychiatry, a source of innovative dispositions for medically ill psychiatric patients, and a source of opportunity for interdisciplinary research.