Toward Defining the Scope of Psychosomatic Medicine Practice: Psychosomatic Medicine in an Outpatient, Tertiary-Care Practice Setting
Abstract
BACKGROUND: Because psychosomatic medicine (PM) is increasingly practiced in outpatient settings, the scope of practice needs to be delineated from community psychiatry and inpatient psychiatry work. OBJECTIVE: The authors sought to address the question of whether outpatient activities are a definably part the scope of practice of PM. METHOD: Three clinical groups were compared: 200 PM outpatients, 200 consultation–liaison (CL) inpatients, and 200 community-psychiatry (CP) outpatients. RESULTS: The groups differed significantly in 49 of 112 demographic and clinical comparisons (43.8%). Analysis of individual measures validated the concept that PM outpatient practice requires traditional PM/CL expertise with medical-psychiatric differential diagnosis, unexplained physical symptoms, pain, and psychopharmacological management in medically ill and geriatric patients. CONCLUSION: Outpatient PM experiences may also enhance training opportunities, given an expanded case-mix.
