Wake-up call for British psychiatry: responses

f) On the other hand, as a GP, I would certainly consider carefully who to refer to secondary care and would use all my skills, as acquired in my GP training, before referral.I would also consult my liaison community psychiatric nurse or other attached mental health professional if I had one, and if necessary consult the consultant psychiatrist over the phone.However, a good GP will expect to be able to refer problems which they cannot solve to secondary care, and then expect the referral to be treated with respect by the consultant psychiatrist colleague with an adequate response, for GPs are specialists in their own right.(g) Finally, in all of this debate, we have entirely forgotten that the reason service users consult doctors is the doctor-patient relationship, which is a relationship based on trust in another person, who may or may not have a greater or lesser knowledge of psychology and neuroscience, but who most of all is a person to be confided in during difficult times.This is what we must be as doctors, and all our discussions about 'the role of the consultant' pales into insignificance before this.We must remember how Sir James Spence defined the consultation: 'The occasion when, in the intimacy of the consulting room, a person who is ill, or believes himself to be ill, seeks the advice of a doctor whom he trusts.This is a consultation'. 2 If we forget this, then what indeed is the point of our being doctors?1