In the majority of the teaching hospital and medical centers within the United States medical and surgical interns are responsible for the initial examination of patients who present themselves in the Admitting Emergency Room. This responsibility is supported by the resident and attending staff of these services as well as the various specialty services of that hospital. Consultation with a more senior physician of the resident or attending staff in many instances is determined solely on the basis of the admitting intern's personal judgment.
In recent years, a few reports have been published on the functions of the psychiatric service in the emergency rooms of general hospitals.1 For the most part, these reports and recommendations for the establishment of psychiatric emergency services in general hospitals have ignored the relationship between the admitting intern who carries the responsibility for initial decisions, who serves at the front
ROBERT SILBERT. Psychiatric Patients In the Admitting Emergency RoomHouse Officer Training in Management. Arch Gen Psychiatry. 1964;11(1):24–30. doi:10.1001/archpsyc.1964.01720250026003