Consults

Uhm, what is it about other services that makes them so loath to deal with psychiatric issues?  This weekend, during my 24 hour call, I had the consult pager for a few hours.  Man, what idiocy!  On the weekends, the Consult Liaison service is not available so the Crisis Residents handle any consults.  This means that the consults need to have an emergency about them–aka, suicidal or homidical thought, intent or plan; me.  It’s the equivalent of asking an ER doctor who is dealing with trauma in her ER to leave and go deal with an issue, so the consults have to be an issue of life/death.

I had one doc consult me b/c one of his patients wanted to speak with a psychiatrist but he wasn’t sure as to what the patient wanted to talk about.  He told me he wasn’t qualified enough to make the decision as to the emergency of the call.  What?  I told him that if it wasn’t a matter of suicidal/homicidal ideation or medication mismanagement or uncontrolled agitation/aggression, he would have to contact Consult Liaison on Monday.  Makes sense to me but unfortunately this transplant surgeon felt otherwise.  After a couple of minutes of wrangling while I attempted to triage this consult (determine its level of emergency), in exasperation I finally asked him if he was a physician and he answered to the affirmative so I asked him if he had even asked the patient if he was suicidal and he told me he wasn’t qualified to assess a patient’s suicidality.  WHAT??!!!

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