Appendix V Consult Etiquette

WHAT IS A CONSULT?

  • Diagnostic or management dilemma that results in a question
  • An opportunity to enhance quality of care by specialist knowledge, experience, and recommendations
  • Learning opportunity for consulting clinician and consultant
  • Skill that requires practice, like any procedure
  • Critical aspect of patient care; for patients’ benefit

Consult versus “Curbside”

  • Consult: Ask for a specialist’s involvement in patient care to help guide diagnostic or therapeutic decisions. The consulting physician is under no obligation to follow the recommendations. Consultants are expected to:
    • Have their name/service in the patient chart.
    • See the patient and write a note.
    • Communicate recommendations to the consulting team.
    • Bill for the encounter.
  • Curbside: Ask a specialist a question without asking for involvement in patient care. Unlike consultants, curbsided specialists should not:
    • Have their names in the patient chart.
    • Write a note in the patient chart.
    • Bill for the encounter.
  • Avoid curbside requests: If the primary team deems one necessary, it should take place only at the attending level, and the specialist should determine whether the question would be better answered as a full, formal consult.

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