A modest proposal for consultation/liaison psychiatry in the 1980s

The authors discuss how consultation/liaison psychiatry has promoted closer cooperation between primary care and psychiatry in the general hospital setting and has increased physician concern for psychosocial issues while at the same time creating financial and organizational problems for consultation/liaison programs. To remedy these difficulties, the authors propose that all general hospitals that have more than 350 beds have fully staffed consultation/liaison services and that these services be funded through third-party reimbursement formulas as an integral hospital-based service. They outline six potential benefits of their proposal and suggest that action must be taken now if consultation/liaison psychiatry is not to suffer the same fate as the community mental health center movement.