Effectively working with consultants

Definition

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

2. More practically, it is a service type provided by a physician whose opinion or advice regarding evaluation or management of a specific problem is requested by another physician.

Six Tenets of Dale Carnegie "How to Win Friends and Influence People

1. Become genuinely interested in other people.


2. Be a good listener.


3. Encourage people to talk about themselves.


4. Make the other person feel important and do it sincerely.


5. Show respect for the other person’s opinions. Don’t say “You’re wrong”.

6. Begin in a friendly way and try honestly to see things from the other’s view.


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.

Communicate/Core Questions

1. Give the diagnosis first and why you are consulting them, e.g. for an admission or a consult. Know your goal before you call them and then state it clearly to them. Don’t say “what do you want us to do?”

Conflict Resolution

1. Do not criticize or question the other physician in front of the patient/family

2. Always maintain professional standards regardless of their behavior

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