The roles which the psychiatric consultant in a general hospital may be called upon to play have been reviewed recently in the literature by Schiff and Pilot.7 They describe 2 fundamental approaches. One is the patient-oriented approach, in which the consultant deals primarily with the patient's difficulties by means of psychiatric evaluation. Schiff and Pilot cite the work of Garret4 and Cushing3 to describe this approach. The other method is the consulteeoriented approach, in which ‟the assumption is made that every psychiatric consultation, if not every consultation, stems from the referring physician's concerns, of which the most cogent are frequently not explicitly stated."7 The referring physician becomes the center of the consultant's interest; the consultant's task becomes to determine what the consultee wants to know, or what he wants the consultant to do, in addition to what he has asked for overtly.