Psychiatric consultation and referral.

Over half of patients with psychiatric problems are seen by primary care physicians. Many of these patients will benefit from psychiatric consultation when the diagnosis is unclear or when the patient is not responding to treatment. Good communication between referring physician, consulting physician, and patient are essential to ensure a good result. Specific problems that should lead to consultation include: patient's request, unclear diagnosis, poor results from treatment, and crisis situations such as suicide attempts. Consultation-liaison psychiatry services in the primary care setting are becoming more popular and are an excellent way of improving communication between primary care physicians and psychiatrists. Further development of this role of the psychiatrist in the primary care setting has great potential of improving the quality of care delivered patients with psychiatric problems who seek care from their primary care physician. It appears that the majority of patients continue to seek care for their psychiatric symptoms from their primary care physician. Open communication and ease of consultation with psychiatrists can make the care of these patients even more rewarding to the primary care physician.