Secondary Logo

What Are We Really Talking About? An Organizing Framework for Types of Consultation and Their Implications for Physician Communication

Hale, Andrew J., MD; Freed, Jason A., MD; Alston, W. Kemper, MD, MPH; Ricotta, Daniel N., MD

doi: 10.1097/ACM.0000000000002659
Perspective: PDF Only
Free
PAP

Consultation amongst providers is a foundation of modern health care and one of the most frequent means of interdisciplinary communication. Accordingly, clear and efficient communication between providers and across medical specialties during consultation is essential to patient care and a collegial work environment. Traditionally, consultation requests are felt to require a clear question that falls within the purview of the consultant’s expertise. However, this narrow constraint is often lacking in the real-world clinical environment, and may in fact be detrimental to physician communication and patient care. In this Perspective the authors propose an organizing framework of seven specific consultation types, which apply broadly across disciplines: ideal, obligatory, procedural, S.O.S., confirmatory, inappropriate, and curbside. The authors describe what factors define each type and the benefits and pitfalls of each. The proposed framework may help providers have more productive, efficient, and collegial conversations about patient care, which may facilitate improved work satisfaction and an enhanced learning environment.

A.J. Hale is an infectious diseases specialist, University of Vermont Medical Center, and assistant professor of medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont.

J.A. Freed is a hematologist, Beth Israel Deaconess Medical Center, and instructor of medicine, Harvard Medical School, Boston, Massachusetts.

W.K. Alston is director of infectious diseases, University of Vermont Medical Center, and professor of medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont.

D.N. Ricotta is a hospitalist, Beth Israel Deaconess Medical Center, and instructor of medicine, Harvard Medical School, Boston, Massachusetts.

Acknowledgements: The authors wish to thank C. Christopher Smith, MD, and Grace Huang, MD, for their invaluable insights and reviews

Funding/Support: None reported.

Other disclosures: None reported.

Ethical Approval: Reported as not applicable.

Correspondence should be addressed to Andrew J. Hale, University of Vermont Medical Center, Infectious Disease Unit, 111 Colchester Avenue, Mailstop 115 SM2, Burlington, VT 05401; telephone: 802-847-2264; e-mail: Andrew.Hale@UVMhealth.org.

© 2019 by the Association of American Medical Colleges