Effectively working with consultants

Quote

“The chief function of a consultant is to make a rectal examination that you have omitted.” Sir William Osler.

Definition

A service type provided by a physician whose opinion or advice regarding evaluation or management of a specific problem is requested by another physician.

Skills for success

1. Organizational skills: Focused. Concise. Prompt. Prepared.

2. Interpersonal/Comm Skills: Polite. Be willing to help. Clear communication

3. Medical knowledge: Accurate. Investigating the problem. Owning the patient.

4. Conflict resolution: Concession. Compromise. Negotiation.

The "5 C's" of ED Consults

1. Contact: Full name. Rank and service. Identify supervisor

2. Communicate: Concise story. Clearly speaking. Clarify issues. Be patient.

3. Core question: Specify the need for the consultant.

4. Collaboration: result of the discussion.

5. Closing the loop: Ensure both parties on same page, update with any changes.

Peer to Peer

When making contact, introduce yourself as “Dr. Smith (not Bill), the EM resident”. You earned your title, so use it. Calling yourself "Bill" the ED resident and addressing the consultant as "Dr. Jones" immediately puts you in a subservient position for the rest of the conversation. For peers, e.g. resident to resident, using first names is acceptable.

References

1. Consultation in the emergency department: a qualitative analysis and review.J Emerg Med. 2012 Jun;42(6):704-11. doi: 10.1016/j.jemermed.2011.01.025. Epub 2011 May 26 2. EMRAP Episode #144 3. http://allbleedingstops.blogspot.com/2007/04