The psychiatrist as a "presence": possible effects on emergency room staff attitudes.

In this preliminary study, the experimental presence of a consulting psychiatrist at medical rounds was instituted in a busy city hospital emergency room. The psychiatrist was instructed only to respond to questions on psychiatric topics. Students were asked to record data from the discussions which occurred both with and without the presence of the psychiatrist. Our results suggest that the passive, supportive presence of a psychiatrist during medical rounds in the E.R. had a significant impact upon medical staff sensitivity to psychological topics as measured by the time spent discussing issues of a related nature. Since the study is limited to the time of the recording, no long-term conclusions can be drawn. Our work does raise significant questions, however, about medical staff sensitization to psychosocial issues and the facilitating effect of the psychiatrist in the E.R. setting.