Consultation-Liaison (C-L) Psychiatry has been an important component of psychiatry for over 70 years and a certified subspecialty under the American Board of Medical Specialties since 2004. Brigham and Women’s Hospital has one of the largest C-L divisions and one of the largest C-L fellowship programs in the country, with a mission to maintain strong bonds between psychiatry and other specialties of medicine.

The Brigham’s leadership and expertise in C-L were on display at the 2018 Academy of Consultation-Liaison Psychiatry (ACLP) annual meeting. There, David F. Gitlin, MD, FACLP, chief of the Brigham’s Division of Medical Psychiatry, joined other Brigham faculty, graduates and physicians participating in nearly 20 percent of the meeting’s presentations.

“The most recent ACLP annual meeting had its highest attendance ever, at nearly 1,100 people,” said Dr. Gitlin, who has served on the ACLP’s board of directors for about 20 years. “The field is growing tremendously, the Academy has more than doubled in size in the last decade and the Brigham is well-represented as a leader in the field.”

The Brigham’s presence at the ACLP annual meeting included leading participation in the following courses and sessions:

• Updates in Perinatal Psychiatry: Negotiating Clinical Challenges in a Rapidly Evolving Field (Concurrent Skills Course) with Leena P. Mittal, MD (fellowship graduate and current faculty member) and Nancy Byatt, DO, FACLP (fellowship graduate)
• C-L Psychiatry and the Opioid Crisis: Clinical Opportunities and Bioethical Practices(General Session) with Joji Suzuki, MD (current faculty); Sejal B. Shah, MD, FACLP (fellowship graduate, current faculty, and the Brigham’s C-LP service director); and Walter Kilpatrick III, DO (fellowship graduate)
• Updates in Psycho-oncology for Psycho-oncologists: Defining the Breadth and Depth of Subspecialty Care for Cancer Patients (General Session) with Fremonta L. Meyer, MD, FACLP (fellowship graduate and current faculty); Eliza Park, MD, FACLP (fellowship graduate); and Kaleena Chilcote, MD (fellowship graduate)

One highlight of the meeting was the final plenary session — a debate on whether marijuana is a legitimate replacement for opioids in pain management. The debate featured Dr. Suzuki, along with J. Michael Bostwick, MD, a graduate of the Brigham and Women’s Hospital C-L fellowship program and now a professor at the Mayo Clinic. It was moderated by Liana Braun, MD, another fellowship graduate of the Brigham who currently serves as chief of the Division of Adult Psychosocial Oncology at the Dana-Farber Cancer Institute.

“The meeting’s focus on the various areas within the subspecialty field of C-L is a good reflection of how the Brigham approaches this intersection of psychiatry and medicine,” Dr. Gitlin said. “We are fully integrated in the house of medicine, with subspecialists focusing on complex patients within virtually every medical and surgical service.”

As examples, Dr. Gitlin pointed to a few of the newer C-L subspecialties at the Brigham, including face and limb transplantation, addiction medicine, critical care psychiatry, trauma-informed care, psycho-oncology and global mental health.

“With six fellowship positions next year in our Brigham program, we also are a major training center, and many of our fellows have received the ACLP’s prestigious Webb Fellowship over the years. In addition, we hold leadership roles in the ACLP and the American Psychiatric Association’s C-L Council,” Dr. Gitlin said, adding that the Brigham currently has 20 board-certified/eligible C-L psychiatrists on staff.  “The future of C-L at the Brigham is bright.”