Psychosomatic Medicine Service
We strive to improve physical and mental health through better understanding and bridging of the mind-body connection. We intend to reach this goal through the following tasks:
- Assisting medical and surgical specialists in the recognition and management of psychiatric complications of medical illness and its treatments.
- Training at all professional levels, including public education the area of psychosomatic medicine.
- Conducting and coordinating clinical research.
Psychosomatic Medicine (PM) is the area of Psychiatry concerned with the psychobiological care of the medically ill. This patient population includes persons of all ages and those cared for in specialized settings such as internal medicine, surgery, organ transplantation, and many others. Psychosomatic Medicine specialists, in addition to providing expert formal psychiatric consultation to medical and surgical patients in the general hospital, specialized hospitals and outpatient clinic settings, also train psychiatrists and non-psychiatrist healthcare providers (e.g., internists, neurologists, surgeons, nurses, physician assistants) in the recognition of normal and abnormal reactions to illness and appropriate psychological care of patients with such reactions.
Thus the Psychosomatic Medicine Service (PMS) functions both as a consultant and as part of the primary medical/surgical treatment team. Via conjoint rounds and teaching conferences (primary intervention), formal consultations (secondary intervention), and involvement in inpatient treatment and discharge planning (tertiary intervention), the PMS provides a comprehensive approach to the emotional, cognitive, and behavioral needs of the patient.
Consultation/Liaison Service: Inpatient Program
The Inpatient Psychiatric Consult -Liaison (C/L) Service provides a critical service to Stanford Hospital & Clinics (SHC) by enhancing the quality of patient care and offering medical colleagues consultation in all psychiatric aspects of patient management. The C/L Service provides consultation in all 16 medico-surgical units at SHC, providing an average of 1200 new consults per year. The services provided include:
- Psychopharmacological consultation for any psychiatric disturbance occurring on the medical/surgical units
- Pre-organ transplant evaluation to assess the patient’s psychological readiness for transplantation, as well as treatment for the psychiatric complications common to the procedure and its medications
- Prevention and management of alcohol and drug withdrawal on the wards
- Competency assessments to participate in the medical decision making process
- Help in the psychiatric aspects of pain management
- Prevention, diagnosis and treatment of delirium
- Psychotherapeutic and pharmacologic interventions for those suffering from cancer, aids and other terminal illnesses, neurological illnesses, and chronic medical processes
- Assistance in the psychopharmacology of intubated patients in the intensive care unit setting
- Assistance of a patient’s family, caregivers, and hospital staff to better cope with psychological distress caused by the illness / death of a loved one
- In a liaison role, helping house staff and nursing personnel deal with difficult patients and understand the psychiatric aspects of medical processes
Psychosomatic Medicine Clinic: Outpatient Program
The outpatient Psychosomatic Medicine Clinic (PMC) offers a number of services for patients usually referred by physicians in other medical specialties. These services include: evaluative sessions to assess for the presence of psychiatric disorders arising as a consequence of medical disorders or their treatment; psychological assessment for the appropriateness for transplantation and other surgical procedures (e.g., deep-brain stimulator for the treatment of Parkinson’s Disease; bariatric surgery, cosmetic surgery and others); psychopharmacological consultations; psychotherapy; and hypnosis training.
We have ongoing subspecialty clinics to provide specialized services to the following medico-surgical specialties: Internal Medicine & specialty services; General Surgery & specialty services; Neuropsychiatry; Solid Organ & Bone Marrow Transplantation; Composite Tissue Allotransplantation; the Positive Care Clinic (HIV/AIDS); and the Comprehensive Cancer Center.
José Maldonado, M.D., FAPM, FACFE
José Maldonado, MD, FAPM, joined the Stanford faculty in 1993 and became Medical Director of the Psychosomatic Medicine Service in 1995. He received his medical degree at Ponce School of Medicine and his psychiatric training at Temple University, in Philadelphia. He completed additional training in Forensic Psychiatry at Temple University, and a fellowship in Consultation-Liaison/Neuropsychiatry at New England Medical Center/Tufts University, in Boston.