One Man Band Psychiatric Consultant

I thought I would make a simple dirty dozen without video to illustrate the bare bones approach of a hit-and-run “one man band” psychiatry consultation service, especially since only one faculty member staffs the service at a time in our hospital. It’s just my approach and I welcome other perspectives. Often, though, it’s been my impression that my colleagues in medicine and surgery expect the psychiatric consultant to help with a number of different tasks. Collaboration is probably the best way to understand patients and help them get through a difficult hospital course.

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While a psychiatry consultation service can be sort of a one man band–it usually works best if all the players are in tune with each other.



  1. Jim – I really like the way you describe your consultation models. “Psychiatric clearance” for discharge following a suicide attempt or the person with suicidal ideation has been a very high volume consultation in the places I have worked. Our colleagues in medicine and surgery often make this a gatekeeper situation as in “you are ready to be discharged from our perspective – we are just waiting for that psychiatrist to get here to discharge you.” If you are the only psychiatrist there on call in a large hospital and you also have to do admissions to psychiatric units, it can be an impossible task. I can recall working from 8AM until midnight and a service being impatient with me for not getting over to their unit by 10:30 PM to “clear” a mildly depressed patient with no clear suicidal ideation.

    At times I think we are viewed as risk management and placement for medical and surgical services.


    • Thanks, George. You hit the nail on the head. We’re so busy “clearing” each other’s rears we take the greatest risk, possibly, in forgetting to care for the patient.

      Great post today on “Adapting to a Mother with Problems.”



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