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Our technique of psychiatric consultation in the practice of internists developed from a strong and realistic need for such teamwork relationship. It so happened that an internist (J. V. T.), who was later joined by two other internists, was particularly interested in the psychiatric and emotional problems of his patients, and that one psychiatrist (M. G.) had sufficient interest in internal medicine to follow the call, and all met on the common ground which we call psychosomatic medicine. An unusual technique and a teamwork relationship developed from these consultations which seem to be beneficial for patient, internist and psychiatrist simultaneously and therefore are, we feel, worth reporting.
It is a modern trend in the administration of hospitals, if at all possible, to arrange for the psychiatrist to work wherever he is needed and to avoid his isolation in special neuropsychiatric wards. Likewise, we started our experiment with the aim in mind not to separate internal medicine and psychiatry, but to allow them to function as two aspects of the same study and treatment situations, which would be destroyed by an artificial splitting.
The disproportion between the number of patients who could be helped by modern psychiatric methods and understanding and the number of trained psychiatrists is continually mentioned as an important problem today by many observers. Various workers are experimenting with different approaches to this problem; Berlin (7) has reported on the psychosomatic seminar and its possible projection into private practice as a form of psychiatric consultation. We feel that our teamwork relationship represents a practical, safe, and effective way to help solve this problem through the internist and general practitioner with the aid of the psychiatrist as a consultant.