I just finished residency about a year ago and have started a job doing psychiatry consults at a community hospital. The consults have been called by the unit clerk, who reads 3-4 words on a paper (something like "depression and anxiety"), then gets the nurse at my request, who will tell me a little more about the patient and their best guess about why the consult was called (although they have rarely spoken with the physician about it). I have actually skipped the step with the nurse recently because it isn't helpful to get their information until I know what I am looking for.
Then I call the physician who called the consult.
This all seems like a lot of wasted time for me. Is it unreasonable to ask other physicians to call consults directly?
I think it is exceptionally rude to order a consult without calling the consultant, especially in areas where some communication is needed. ie: psych. Is this institutional at your hospital, or do they only not call psych? Maybe the prior/ other psychiatrists did not want to be called? I would probably let the docs know that you would like to be called. Hopefully after you tell a few, word will get around. If you have a hospitalist group, perhaps you could stop by their monthly or quarterly provider meeting to just explain your preference to be called. Good luck!
ResidentMom<br /><br />"If you bungle raising your children, I don't think whatever else you do well matters very much." --Jackie O.
Thanks! This wasn't the norm where I did residency, but I know things are different at academic hospitals.
I am going to the internal med meeting next month, and all of the hospitalists and most of the community docs who round in the hospital will be there. I will just let them know that I would appreciate being called directly. Meanwhile, I will say something one at a time as consults come in. I just wanted to be sure this wasn't an odd request. It is a very small hospital, and I don't want to piss anyone off (or at least not too many people).
There hasn't been a psychiatrist here for 10 years, so I have a lot of room to do things my way
At the last hospital I worked at, physician-to-physician communication was mandatory if a consult was ordered. Physician could write the order but HUC would not call the consultant. This was hospital-wide policy.
In my experience as a consultant at both community and academic hospitals, it is very common to not get called by a physician for a consult in the community hospital setting, and sometimes also in the academic setting (particularly if there is no resident involved in the patient's care). I do not see this as bad form, but rather see it as a reflection of how busy many physicians are.
My approach to this is to go with the flow and to call the patient's attending if I have questions. I would probably never require a physician to call me directly unless it were hospital policy.