Clinical Services

 

Patients who suffer from medical and surgical illnesses frequently develop neuropsychiatric complications in addition to exacerbations of pre-existing psychiatric disorders, for which our psychiatrists and psychologists provide expert diagnostic and management interventions.

Our psychiatrists are skilled in the use of psychopharmacology in the medical setting and consultation psychiatrists here pioneered the use of intravenous haloperidol for agitation, psychostimulants for depression in the medically ill and lorazepam for catatonia.


Our service sees approximately 9% of the 43,000 yearly admissions to the Massachusetts General Hospital. It is one of the busiest consultation services in the hospital and many types of patients are diagnosed and treated.

For example, we care for the delirious patient in the CCU on an intra-aortic balloon pump whose agitation is life threatening and for the pancreatic cancer patient with suicidal depression and for the elderly stroke victim with depression who needs treatment to help with mobilization for rehabilitation. Psychotic symptoms in medical patients with severe psychiatric disorders or seizures are managed by our team as are the behavioral problems of those with personality dysfunction. On occasion we determine whether patients have the capacity to make life and death medical decisions and we help care for patient needs at the end of life. We aid patient adjustment to modern medical technology and treat the anxiety of the illness experience. A wide array of medical psychiatry challenges such as these are met each day by our specialist psychiatrists and our fellows and residents.

Service Descriptions

The Avery Weisman Psychiatric Consultation Service and the Resident Psychiatry Consultation Service, under the direction of Ted Stern, trains residents from the MGH/McLean Residency in four month, half-time rotations during their PGY III year. There is also a Chief Resident in the fourth year chosen to serve on the Consultation team. Attendings on the service, including Ted Stern, Cornelia Cremens, Halyna Vitagliano, Jeff Weilburg, Jack Purcell, Ned Cassem, Donna Greenberg and Greg Fricchione staff consultations from every part of the hospital with the residents, providing state of the art medical psychiatric care. The Fellows Consultation Service, under the direction of Greg Fricchione and George Murray, educates 3 PGY V graduate psychiatrists each year. They receive a graduate school level course in clinical neuroscience along with intensive clinical training. Graduates of the Fellowship have gone on to become leaders in medical psychiatry.

The Transplant Consultation Service is comprised of several seasoned psychiatrists working on organ specific teams. Owen Surman sees kidney and adult liver recipients and donors. Laura Prager sees lung transplant recipients. Heart transplant recipients are seen by Jack Purcell and Steve Schlozman evaluates young liver recipients. These transplant psychiatrists make essential contributions to the transplant teams they serve and to the patients and families they treat.

The Cox Psycho-Oncology Service is ably represented by internist-psychiatrist Donna Greenberg, a leader in the area of depression and cancer. She works closely with the Breast Cancer Center. Ned Cassem, Professor of Psychiatry and former Chairman in our Department attends in the Prostate Cancer Disease Center and in the Gynecologic Oncology Center. William Pirl also works in the Prostate Cancer Disease Center. Halyna Vitagliano sees brain tumor patients in the Neurooncology Disease Center. These devoted psychiatrists work closely with patients and families who often are facing the loss experiences brought about by cancer.

Paula Rauch directs the Pediatric Consultation-Liaison Service. She is assisted by an energetic group of child psychiatrists including Nina Muriel, Annah Abrams and Lawrence Selter. These psychiatrists are skilled in helping young people meet the developmental challenges of illness. Among the many worthwhile initiatives of the pedi C-L team, there is the innovative Parenting At a Challenging Time or PACT program, begun by Paula Rauch. This MGH Cancer Center Program provides parent guidance consultations to adults with cancer who seek assistance in helping their children cope with parental illness.

The Burn Consultation Service has child and adolescent as well as adult components. Frederick Stoddard has for years run the psychiatry program at the renowned Shriner’s Burn Hospital. His innovative work with post-traumatic stress disorder (PTSD) in young burn victims has won acclaim. John Findley works closely with the Adult Burn-Trauma Unit at MGH as a valued member of their team. The Burn Psychiatry Service is an important buffer against staff burnout. In the tradition of MGH psychiatrists who cared for the burn victims of the 1942 Cocanut Grove disaster, the Burn Consultation Service has provided state of the art care for the victims of the recent Rhode Island “Station” nightclub fire.

In the MGH Internal Medicine Associates Center, the Primary Care Psychiatry Service has a special role to play. Indeed this consultation service is the only specialty service granted space by the primary care internists signifying their appreciation of how essential the primary care psychiatry team is. Carol Wool runs this service. They are assisted by an excellent staff, which includes psychiatrists Anne Emmerich, Robert Birnbaum, Nasri Jacir, Edith Geringer and psychologist Cathy Conboy.

The Women's (Perinatal and Reproductive Psychiatry) Consultation Service under the direction of Laura Petrillo-Fagioli sees pregnant and post-partum women with psychiatric conditions. It is essential for the mother to negotiate the obstetrical experience with the best mental health possible and this service works hard to insure this so that the baby and the family can get off to the best start possible.

The Cardiovascular Health Service is staffed by Jack Purcell, a psychiatrist with expertise in cardiac psychiatry. This service has developed an integrated program of behavioral health, which has benefited patients undergoing cardiac rehabilitation at MGH. This is especially important since mood disturbance can precipitate and exacerbate cardiac disease.

The Spaulding Rehabilitation Hospital Behavioral and Mental Health Service, under the leadership of Scott Rauch, has an experienced, dedicated staff of psychiatrists, psychologists and neuropsychologists who specialize in the diagnosis and management of the emotional, cognitive and behavioral problems of those requiring rehabilitation from illness and injuries. Psychiatrists Lucienne Cahen, Donna DiGioia, Anne Emmerich, Jacob Holzer, Nasser Karamouz, and Eric Leskowitz and psychologists Chris Carter, Richard Goldberg, Tim Wallace and Alan Witkower; and neuropsychologists Thomas Deters, Karren Bekken, Murdo Dowds, Roberta Gallagher, and Bill Rinn perform vital services for the well being of Spaulding patients and their families.

The Infectious Disease Consultation Service is directed by Oliver Freudenreich. He provides evaluation and treatment services to patients seen in the Infectious Disease Clinic, many of whom are diagnosed with HIV-AIDS.

The Gastroenterology Consultation Service is staffed by Brian Keefe who evaluates and treats gastroenterology clinic outpatientsmany of whom sufferfrom inflammatory bowel disease.

The Trauma Consult-Liason Service involves the rounding of John Findley with the multidisiplinary trauma team.

   
 
     
 
 © 2005 Massachusetts General Hospital