Consultation Outcomes: The Psychiatrist as Consultee

The frequent coexistence of psychiatric and medical illness supports the need for excellent medical care on inpatient psychiatric services. Effective use of consultation is an important element in ensuring this care. In our study of midicalsurgical consultation to an inpatient psychiatric service during a two-year period, outcome variables, such as frequency of and concordance with drug and diagnostic action recommendations, were determined and compared with similar data for psychiatric consultations to medical-surgical services. Thirtyeight percent of cases received a consultation. Patients seen by a consultant had a longer hospital stay. Twenty-seven and forty-six percent of consultations contained a drug or a diagnostic action recommendation, respectively. The concordance of psychiatric consultees was 79% for drugs and 75% for diagnostic action recommendations. Comparison with medicalsurgical consultations done by psychiatric consultants revealed important differences and similarities.