What’s in a consult?

February 15, 2010

I happily went into anesthesia for the acute patient care, procedures, pharmacological/physiological immediate impact of my decision-making…. and no clinic visits.

Today, I’m covering the acute pain service on call.  My pager just went off for a consult.  A patient who is about 3 weeks out from an abdominal procedure.  This patient has been on chronic pain meds as well.  Not only do I get a page from the secretary on the floor to come see this patient…the secretary gives me attitude.  This is definitely NOT what I bargained for when I made the decision to become a doctor.

So, if you’re going to order the consult let’s follow these simple steps:

1) The primary service ordering the consult should page and make direct contact with the consult service.

2) Have all the information ready: i.e. last surgery, type of surgery, previous/home meds, and reason for the consult.

3) Be polite — the consult service is happy to help, but it makes it difficult when you bark orders.  We’re all colleagues…let’s add some professionalism to the mix.

4) When the consult service makes recommendations, please follow them.  If you ‘re not going to do the recs, then don’t place the consult.  If you want a “curbside” opinion, say so.

5) Make sure you page the correct consult service.  For example, we have an acute pain service and a chronic pain service.  Unless this patient has had surgery in the last 5 days, it’s a chronic pain consult.

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