(a)
The number of in-patient general consults now seen averages almost
3 per day. For in-patient transplantation-candidate consultations,
the daily average has increased to about 4. As a reflection of the
better working relationships we have developed with our transplantation
colleagues, we have been invited to participate in some of their
formal and informal teaching activities. In addition, a collaborative
research protocol concerning liver transplant patients is in the
early stages of planning.
(b)
Over the past 2 years, there has also been a marked increase in
consultations in cases of suspected non-epileptic seizures (NES),
currently averaging about 2 per week. Because of the positive regard
our neurological colleagues have for our efforts with their NES
patients, they have recently mandated that our service be automatically
called as soon as a patient with possible NES is admitted, rather
than waiting until NES is confirmed by video-EEG monitoring. As
with our liver transplant colleagues, we are in the early stages
of developing with our NES colleagues a clinical research protocol
involving this patient population.
(c)
Transforming the general C/L outpatient program to a specialized
one, we now provide clinical services, about 7 hours a week, to
post-liver transplantation patients. In accordance with a well known
principle of C/L work, these services are rendered in the post-liver
transplant outpatient clinic (rather than a psychiatric clinic setting)
so as to increase the receptivity to, and compliance with, such
services, the need for which is significant. That setting also facilitates
informal liaison teaching activities with the liver transplant nursing
and medical staffs. The C/L activities in this setting are one component
of the C/L electives for students and residents.
(d)
In addition to C/L rounds, a weekly C/L seminar for the residents
and students on the service has been established. Not only is their
active participation in the discussions expected, but they are required
to provide written answers to the written questions that are routinely
assigned with the reading assignments.
(e)
We are in the early stages of planning clinical and education services
as part of the Psycho-Oncology Program of the Winship Cancer Institute
which is described elsewhere in this report.
(f)
Expansion of involvement of the C/L division with our colleagues
in the Department of Otolaryngology has occurred by providing services
to deaf patients who are being considered for cochlear implants.
We are averaging about 1 such referral a month. Evaluations of patients
participating in the Emory Reproductive Center’s in-vitro
fertilization program, either as recipient- or donor-candidates
is expanding as well. We are expecting a monthly average of about
4 cases.
(g)
Both C/L attendings also have recently begun teaching 1st- and 2nd-year
medical students in their problem-based learning course. The main
goal is to help them learn to use the biopsychosocial model; secondary
is to increase interest in psychiatry as a career.
(h)
There has been a marked increase in the number of 4th-year students
from other medical schools who have enrolled for an elective on
our service.
