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Psychiatry today is an enterprise beset by paradox. Its practitioners in the 1980s have reasserted clinical and cultural authority by reaffirming their medical identity. This reaffirmation rests on an increasingly credible biologic basis. Developments in the somatic treatment of depression, anxiety disorders, and the psychoses have been steady. Dramatic advances in the neurosciences may portend a new surge in clinical innovation. Yet, in basing their case for legitimacy on their claim to biologic physicianhood, psychiatrists risk undermining the credibility of much that they can offer. For in its most extreme form, the biologic ideal reduces to a cartoon that permits no place for psychiatry's rich diversity of psychological and social interventions. TheMassachusetts General Hospital Handbookavoids this error. The product of a single, medically oriented department of psychiatry, its main focus is the psychiatrist's role as consultant in the general hospital. Its 30 compact chapters address myriad dimensions of
M. Gregg Bloche (Fri,) studied this question.