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First on-call psychiatrist: resident or non-resident?

Leeds Mental Health Teaching NHS Trust, Leeds, email: drpvikram{at}yahoo.com,

Vivek Agarwal, Senior House Officer

Leeds Mental Health Teaching NHS Trust, Leeds

Mason et al (Psychiatric Bulletin, September 2006, 30, 329–333) described the first on-call activity of senior house officers. We have differing views about whether the first on-call psychiatrist can function as a non-resident. Medical problems in psychiatric in-patients requiring urgent attention (such as chest pain and falls) do not always necessitate transfer of the patient to a medical/accident and emergency setting. Deciding whether to transfer a patient can be difficult without proper physical examination and relevant investigations. A resident doctor would speed up this process; any delay in such situations can compromise patient care.

There are certain clinical situations (such as agitation not responding to deescalation) when a rapid response is necessary if patient and staff safety is not to be compromised. The effects of delay in such a situation are not easily measurable and Mason et al did not attempt to measure this. Hence the conclusion that ‘there was no evidence that a resident doctor increased patient safety’ is not justifiable.

Serious medical emergencies requiring rapid responses are thankfully rare, but equally inevitable. Such a small-scale study raises the question of a type II error.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Palanisamy, V. Articles by Agarwal, V. Search for Related Content PubMed Articles by Palanisamy, V. Articles by Agarwal, V.