Physician preferences for elements of effective consultations

Boulware, David R.; Dekarske, Adrienne S.; Filice, Gregory A.
January 2010
JGIM: Journal of General Internal Medicine;Jan2010, Vol. 25 Issue 1, p25
Academic Journal
journal article
Background: Effective communication is vital for optimal medical consultation, but there is little current information about physician preferences for effective consultation.Methods: We invited physicians with at least one post-graduate year of experience at four Minnesota teaching hospitals to complete a 16-question Internet questionnaire about inpatient consultations.Results: E-mail requests were received by an estimated 651 physicians. Questionnaires were completed by 323 (50%). Of these, 54% had completed training >5 years before, 17% had completed training <5 years before, and 30% were residents or fellows. Three elements were considered essential in consultation requests by most respondents: the specific question to be addressed (94%), whom to call with the response (68%), and consultation urgency (66%). In the consultation note, 71% of subjects placed high importance on simple, concise recommendations and 64% on the rationale behind them, while only 7% placed high importance on citing references. Most (69%) preferred that assessments and recommendations be written in bulleted or numbered format. A plurality (48%) preferred that assessments and recommendations be separated. Most placed high value on recommendations regarding drug therapy that specify dose (80%), duration (80%), and generic medication name (62%). Requesters placed greater importance than consultants (87% vs. 65%, respectively, P = 0.004) on recommendations that included duration of therapy. The majority (63%) stated that telephone requests were needed for emergent or urgent consultations. Those who usually requested consultations were more likely than those who usually responded to consultation requests to prefer telephone requests for routine consultations (43% vs. 20%, P < 0.001).Conclusions: Physicians agreed on many essential elements for effective consultations. These results should guide efforts to improve communication in the consultation process and design electronic medical record systems.


Related Articles

  • Stereotype threat and health disparities: what medical educators and future physicians need to know. Burgess, Diana J.; Warren, Jennifer; Phelan, Sean; Dovidio, John; Van Ryn, Michelle // JGIM: Journal of General Internal Medicine;May2010, Vol. 25, p169 

    Patients' experience of stereotype threat in clinical settings and encounters may be one contributor to health care disparities. Stereotype threat occurs when cues in the environment make negative stereotypes associated with an individual's group status salient, triggering physiological and...

  • Comparing in-person, video, and telephonic medical interpretation. Locatis, Craig; Williamson, Deborah; Gould-Kabler, Carrie; Zone-Smith, Laurie; Detzler, Isabel; Roberson, Jason; Maisiak, Richard; Ackerman, Michael // JGIM: Journal of General Internal Medicine;Apr2010, Vol. 25 Issue 4, p345 

    Background: Using trained interpreters to provide medical interpretation services is superior to services provided on an ad hoc basis, but little is known about the effectiveness of providing their services remotely, especially using video.Objective: To compare remote...

  • Physician specialization and antiretroviral therapy for HIV. Landon, Bruce E.; Wilson, Ira B.; Cohn, Susan E.; Fichtenbaum, Carl J.; Wong, Mitchell D.; Wenger, Neil S.; Bozzette, Samuel A.; Shapiro, Martin F.; Cleary, Paul D. // JGIM: Journal of General Internal Medicine;Apr2003, Vol. 18 Issue 4, p233 

    Background: Since the introduction of the first protease inhibitor in January 1996, there has been a dramatic change in the treatment of persons infected with HIV. The changing nature of HIV care has important implications for the types of physicians that can best care for patients...

  • Hand-off education and evaluation: piloting the observed simulated hand-off experience (OSHE). Farnan, Jeanne M.; Paro, John J. M.; Rodriguez, Renee M.; Reddy, Shalini T.; Horwitz, Leora I.; Johnson, Julie K.; Arora, Vineet M.; Paro, J A M; Rodriguez, R M; Reddy, S T; Horwitz, L I; Johnson, J K; Arora, V M // JGIM: Journal of General Internal Medicine;Feb2010, Vol. 25 Issue 2, p129 

    Aim: The Observed Simulated Hand-off Experience (OSHE) was created to evaluate medical students' sign-out skills using a real-time assessment tool, the Hand-off CEX.Setting: Thirty-two 4th year medical students participated as part of an elective course.Program...

  • A strategy for improving health disparities education in medicine. Ross, Paula T.; Cené, Crystal Wiley; Bussey-Jones, Jada; Brown, Arleen F.; Blackman, Dionne; Fernández, Alicia; Fernández, Leonor; Glick, Susan B.; Horowitz, Carol R.; Jacobs, Elizabeth A.; Peek, Monica E.; Wilkerson, LuAnn; Lypson, Monica L.; Wiley Cené, Crystal; Fernández, Alicia; Fernández, Leonor // JGIM: Journal of General Internal Medicine;May2010, Vol. 25, p160 

    Introduction: A health disparities curriculum that uses evidence-based knowledge rooted in pedagogic theory is needed to educate health care providers to meet the needs of an increasingly diverse U.S. population.Description: The Health Disparities Education: Beyond...

  • Surmounting the unique challenges in health disparities education: a multi-institution qualitative study. Carter-Pokras, Olivia; Bereknyei, Sylvia; Lie, Desiree; Braddock, Clarence H.; Braddock, Clarence H 3rd; National Consortium for Multicultural Education for Health Professionals // JGIM: Journal of General Internal Medicine;May2010, Vol. 25, p108 

    Background: The National Consortium for Multicultural Education for Health Professionals (Consortium) comprises educators representing 18 US medical schools, funded by the National Institutes of Health. Collective lessons learned from curriculum implementation by principal...

  • Not perfect, but better: primary care providers' experiences with electronic referrals in a safety net health system. Kim, Yeuen; Chen, Alice Hm; Keith, Ellen; Yee Jr., Hal F.; Kushel, Margot B.; Yee, Hal F Jr // JGIM: Journal of General Internal Medicine;May2009, Vol. 24 Issue 5, p614 

    Background: Electronic referrals can improve access to subspecialty care in safety net settings. In January 2007, San Francisco General Hospital (SFGH) launched an electronic referral portal that incorporated subspecialist triage, iterative communication with referring providers,...

  • Short-Term Outcomes for Opiate and Crack Users Accessing Treatment: The Effects of Criminal Justice Referral and Crack Use. Jones, Andrew; Hayhurst, Karen P; Millar, Tim; Pierce, Matthias; Dunn, Graham; Donmall, Michael // European Addiction Research;2015, Vol. 21 Issue 3, p145 

    Background/aims: The English drug treatment population doubled in size between 1998 and 2008, increasingly characterised by crack cocaine use and criminal justice system (CJS) referral. We assessed short-term (median 3.5 month) behaviour changes following participation in drug...

  • Missed Opportunities for Measles, Mumps, Rubella Vaccination Among Departing U.S. Adult Travelers Receiving Pretravel Health Consultations. Hyle, Emily P; Rao, Sowmya R; Jentes, Emily S; Fiebelkorn, Amy Parker; Hagmann, Stefan H F; Walker, Allison Taylor; Walensky, Rochelle P; Ryan, Edward T; LaRocque, Regina C; Parker Fiebelkorn, Amy; Taylor Walker, Allison // Annals of Internal Medicine;5/16/2017, Vol. 166 Issue 10, pN.PAG 

    Background: Measles outbreaks continue to occur in the United States and are mostly due to infections in returning travelers.Objective: To describe how providers assessed the measles immunity status of departing U.S. adult travelers seeking pretravel consultation and to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics