OBJECTIVE This article describes the evolution of a primary care geriatric psychiatry program which serves clinical, educational, and research functions. METHODS Program development proceeded through stages of liaison using research, focusing on primary care attendings, and developing the common interest of geriatrics. RESULTS Collaborative research with external funding has continued. A geriatric psychiatry primary care fellowship program was established. Clinical activity is based on consultation-liaison work in nursing homes, an outpatient dementia clinic, a general hospital medical service, and the outpatient clinic. Fellows are involved in training both psychiatry and primary care residents. CONCLUSIONS Necessary components of a successful collaboration include: 1) primary care physicians with an interest in and aptitude for psychiatric issues; 2) delivery of service and training based on an assessment of the primary care site's needs; 3) a physical presence in the primary care site.