The fellow is responsible for the consultation service and oversees the work of the residents in conjunction with an attending physician. Also, patients who are living in the community, but who are experiencing major problems which threaten their current level of independence, can be admitted for an intensive inpatient evaluation including psychiatric and rehabilitation services. Consultations to other surgical and medical services are of the more traditional type with advice but not direct responsibility for management. Members of the Department of Rehabilitation Medicine, the Division of Neurology, and the Department of Psychiatry regularly participate in teaching and team conferences. There is a active geropsychiatry program at Harborview.
Fellows also participate in the geriatrics clinic each week.
A special relationship exists with the strong geropsychiatry group. This activity is integrated with the general medicine consultation service. This service is directed by a full-time faculty member of the Division of Gerontology and Geriatric Medicine, with the assistance of a nurse practitioner. The clinical and teaching program includes longitudinal care for a panel of patients, weekly attending rounds, and twice-monthly conferences on clinical problems in nursing home care or management issues of a nursing home practice. There is also a one- month block experience to reinforce interdisciplinary team care and to learn skills related to the role of a medical director of such facilities.