Consult-Liaison Psychiatry

Focus

The adult Consult-Liaison Psychiatry Service is made up of three collaborative and multidisciplinary teams that include attending psychiatrists, attending psychologists, psychiatry second-, third-, and fourth-year residents, medical students, physician assistant students, psychology doctoral interns, advanced practice providers, and licensed clinical social workers.

We offer psychiatric and psychological consultation to the medically ill patients at Parkland Memorial Hospital, UT Southwestern University Hospitals, and the Dallas Veterans Affairs Medical Center (VAMC), and we provide education, emotional support, and assistance with treatment and discharge planning to the primary care medical teams caring for these patients. The Consult-Liaison Psychiatry teams work to ensure positive outcomes for both patients and medical teams. We also work in outpatient clinical settings such as diabetes, hematology-oncology, maternal fetal medicine, integrated internal medicine-psychiatry clinics, and integrated family medicine-psychiatry clinics.

Leadership

Dr. Orsak
Dr. Catherine Orsak

Catherine Orsak, M.D., is Medical Director of the Consult-Liaison Psychiatry Service at UT Southwestern University Hospitals, Program Director of the UT Southwestern Consultation-Liaison Fellowship Training Program, and a Professor in the Department of Psychiatry at UT Southwestern. Dr. Orsak completed her fellowship training in 1995 at Georgetown University Medical Center, is board certified in CL psychiatry, and has practiced CL psychiatry for over 25 years.

 

 

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Dr. Pedro Fernandez

Pedro Fernandez, M.D., is Medical Director of the Consult-Liaison Psychiatry Service at Parkland Memorial Hospital, interim Co-Chief of Psychiatry at Parkland, and an Assistant Professor in the Department of Psychiatry at UT Southwestern. Dr. Fernandez completed his fellowship training at Yale, is board certified in CL psychiatry and Addiction Medicine, and is interested in behavior health integration and refugee care.

 

 

Dr. Michael Rafferty
Dr. Michael Rafferty

Michael Rafferty, M.D., is Medical Director of the Mental Health Consult-Liaison Team at the Dallas VAMC and an Associate Professor in the Department of Psychiatry at UT Southwestern. Dr. Rafferty is board certified in CL psychiatry and is interested in delirium.

 

 

 

 

Education and Training

The Consult-Liaison Psychiatry Service offers a Consultation-Liaison Psychiatry Fellowship (accredited by the Accreditation Council for Graduate Medical Education since 2007) that combines educational and teaching opportunities with inpatient consultation and ambulatory patient care activities. Fellows are active in:

  • Teaching and supervising residents and medical students
  • Conducting didactics and teaching rounds
  • Attending departmental and university lectures and conferences
  • Providing training and support to inpatient primary care and ancillary care teams
  • Addressing complex inpatient consultation and treatment needs
  • Collaborating with colleagues in other medical specialties in outpatient consultation settings
  • Participating in journal club, critical incident conferences, quality improvement projects, and scholarly activities

In addition to CL Psychiatry fellows being part of the Consult-Liaison Psychiatry Service, Addiction Psychiatry fellows also train and provide care on the Consult-Liaison Psychiatry Service at Parkland under Kapila Marambage, M.D., who started the comprehensive addictions services at Parkland and was awarded Consultant of the Year by the Hospitalist Service in 2018 for this service.

The Consult-Liaison Service features a weekly conference with a guest speaker every Monday. Although the conference is primarily targeted to those currently rotating on the Consult-Liaison Psychiatry Service at Parkland Memorial Hospital and UT Southwestern University Hospitals, meetings are open to other interested faculty, staff, and students. Residents also have the opportunity to present case conferences with the consulting faculty of their choice, allowing for group discussion of treatment protocols and ethical implications in complex cases.

We offer a monthly Journal Club, as well as daily educational and staffing rounds with the attending faculty. Medical students attend regular teaching rounds and are evaluated on their presentation skills. Psychology interns at Parkland Memorial Hospital attend weekly didactics and receive regular supervision and consultation from attending faculty.

The Consult-Liaison Service has also created the Psychiatry Student Interest Group (PSIG), overseen by faculty leader Lia Thomas, M.D. Since 1981, PSIG has organized events and volunteer opportunities for students at UT Southwestern interested in psychiatry as a topic and career. It aims to increase awareness of psychiatry, introduce students to faculty, and provide an environment for exploration and discussion of the psychiatry field beyond the classroom. PSIG has presented medical students, interns, residents, faculty, and staff with informative and innovative lectures on a variety of topics.

Many CL psychiatry faculty are psychiatry mentors in the UT Southwestern Colleges program and are paired with an Internal Medicine or other primary care physician to meet with a small group of medical students periodically during their first year and a half of medical school to develop interview skills, perform physical and mental status examinations, and explore certain topics such as wellness, cultural medicine, social and spiritual history, and ethics.

Research

Several members of the Consult-Liaison Service have been or are currently involved in ongoing research, both within and outside the Department of Psychiatry.

Dr. Jenkins
Dr. Celia Jenkins

Celia Jenkins, M.D., is a Professor in the Department of Psychiatry at UT Southwestern. Dr. Jenkins is board certified in CL Psychiatry and created the CL Psychiatry Fellowship at UT Southwestern in 2007. Dr. Jenkins is a gifted and dedicated educator and has earned numerous teaching awards throughout her career, including the prestigious University of Texas system-wide UT Regents’ Outstanding Teaching Award in 2013. Dr. Jenkins instigated the implementation of the Clinical Institute Withdrawal Assessment (CIWA) at Parkland and wrote a modified version of the protocol specifically tailored to the unique demands of the Parkland environment. The CIWA protocol has become the gold standard in determining appropriate medication dosing, shortening length of patient admissions, and maximizing positive health outcomes for patients experiencing alcohol withdrawal symptoms. Dr. Jenkins also served as a consultant on the development and piloting of a delirium protocol utilizing the CAM-ICU (Confusion Assessment Method) at Parkland.

Dr. Roaten
Dr. Kimberly Roaten

Kimberly Roaten, Ph.D., is an Associate Professor in the Department of Psychiatry at UT Southwestern, Director of Quality for Safety, Education, and Implementation at Parkland, and a Senior Fellow at The Meadows Mental Health Policy Institute. Dr. Roaten’s research focuses on developing strategies for improving suicide risk detection in health care systems. Dr. Roaten leads the Universal Suicide Screening Program at Parkland, work that has been recognized by The Joint Commission and was included as a case use example, resulting in the 2017 HIMSS Davies Award of Excellence for Parkland.

Patient Care

Students, residents, and fellows rotating on the Consult-Liaison Services gain exposure to diverse patient populations, reflecting a variety of ethnic, socioeconomic, and cultural backgrounds. Parkland Memorial Hospital is a Dallas county hospital with a complex, multifaceted patient population. Parkland’s position as an internationally renowned center for trauma and burn services also provides trainees with varied and challenging treatment and consultation opportunities. Parkland has psychiatrists working in collaborative care outpatient clinics in diabetes, hematology-oncology, maternal fetal medicine, integrated internal medicine-psychiatry clinics, and integrated family medicine-psychiatry clinics.

UT Southwestern William P. Clements Jr. University Hospital is the inpatient home of the Peter O’Donnell Brain Institute and allows for consultation with neurology colleagues and their patients with complex and often rare neurological conditions. The UT Southwestern solid organ transplant program is also based at the William P. Clements Jr. University Hospital. Ben Lippe, Ph.D., is an Assistant Professor in the Department of Psychiatry at UT Southwestern, and as the first embedded psychologist within the solid organ transplant program, he has contributed to the development of various transplant candidate selection protocols (e.g., substance abuse guidelines) that have been adopted for continued use within the programs. Dr. Lippe’s research focuses on various aspects within Health Psychology, including peer-reviewed publications on chronic pain management and psychotherapy within hospital settings. Natalia S. David, Psy.D., is an Assistant Professor in the Department of Psychiatry at UT Southwestern with specialties in Behavioral Sleep Medicine and Pain Psychology. Dr. David’s work in sleep and pain psychology across inpatient and ambulatory services has strengthened the integration of multi- and interdisciplinary team-based approaches to patient care at University Hospitals, and she has been invited to speak on these topics at a variety of patient-centered and faculty and resident wellness events across campus departments.

The Dallas VAMC provides clinical and research opportunities to work with veterans with a variety of medical and psychiatric conditions, including traumatic brain injury, posttraumatic stress disorder, and spinal cord injuries. Additionally, the VAMC is a national health care leader in collaborative care with psychiatrists and other mental health professionals working closely with other medical primary care and specialty physicians, including the Primary Care Mental Health Integration outpatient clinic.

Providers on the Consult-Liaison Services receive multiple opportunities to enhance their clinical, communication, leadership, and teambuilding skills as they serve a patient population at UT Southwestern that presents from a variety of cultural and socioeconomic backgrounds, speaks a variety of languages, and may present with extremely complicated medical, neurological, psychiatric, and social histories.