WHAT THE REQUEST FOR CONSULTATION SAYS - COMPARED TO WHAT THE REFERRING PHYSICIAN ACTUALLY EXPECTS FROM THE PSYCHOTHERAPEUTIC CONSULTANT

In consultation-liaison psychiatry and psychotherapy, a discrepancy of ten exists between the exact request for consultation by the referring physician and what he actually expects from the psychotherapeutic con sultant. Usually, the referring physician asks for an examination or f or treatment of a patient. But often the physician has other unsaid ex pectations such as the following four examples: (1) the referring phys ician actually wants to pass a problem patient to another department; (2) the consultant is actually expected to fill the role of a clergyma n; (3) the referring physician actually wants to hand the responsibili ty for a medical decision to the consultant; and (4) the referring phy sician actually wants support for himself. If the consultant directly mentions these issues, which he presumes to be evident, it may lead to interpersonal conflicts. In the following article, several causes of this problem are discussed and analyzed. A good cooperative relationsh ip between the referring physician and the consultant; interdisciplina ry case conferences, and joint talks with patients may help solve thes e problems.