Because many of these symptoms can occur as part of everyday life, and because taking psychiatric drugs can have unanticipated medical, psychological, and social consequences, careful history taking, assessment, diagnosis, and monitoring are required. Consultation-liaison psychiatrists are also concerned with the psychological side effects of nonpsychiatric drugs. Patients taking the anti-ulcer medication cimetidine, for example, can become confused. Conversely, psychiatrists attend to the medical side effects of psychotropic medications. Patients taking lithium, a mood stabilizer used in manic-depressive disorder, can develop tremor.
Medicine lacks the precision of pure mathematics.
When patients' initial complaints are subjective, medical findings subtle, and diagnosis not readily apparent, emotional friction can develop between patient and doctor. Consultation-liaison psychiatrists can help sort out the occasional lapses in communication, empathy, and continuity of care which inevitably occur. Finally, specialists, including consultation-liaison psychiatrists, can help with problems of referral. A long-standing cause of restricted access to medical care for musicians in this country has been lack of insurance coverage. Yet even when they have, and when referral to specialists is appropriate, obtaining a referral may not be easy.