Chaplain and psychiatrist as ally-rivals.

Chaplain and psychiatrist share professional concern for the improved psychological health of the distressed general hospital patient. Commonality of concern suggests regular consultative co-presence and associated interprofessional collaboration. This study of consultation within one teaching hospital finds that co-presence occurs in less than five percent of potential cases and that collaborative exchange in connection with those cases is rare, a condition supported by psychiatric staff and found regrettable by chaplains. "Case-typing," guided by outlooks of secularization (chaplain), scientism (psychiatrist), and traditionalism (ward internist), provides an accounting of collaborative underutilization, supplemented by considerations of organizational structure and positional power.