Psychiatry and primary care as neighbors: From the promethean primary care physician to multidisciplinary clinic

Objective: A successful eight-year experience developing a co-practice model for psychiatry in a primary care practice is described. Methods: The effect on service delivery of specific changes in availability, shared location, and consistency of interdisciplinary relationships are discussed. Results: The following components of successful collaboration were identified: 1) The importance of fiscal organization and leadership factors in creating a successful bridge between psychiatry and primary care. 2) How individual tailoring for the setting (rural vs. urban) affects the collaboration. 3) Adaptations incumbent upon psychiatrists to function well in such settings. 4) The development of a teaching program and training track for medical and psychiatric housestaff in such settings. Conclusions: Making psychiatry accessible at the front line of primary care enhances delivery of care and does not detract from any service.