At my institution we do not do face to face/phone to phone talk with consulting MD's. There is not time, and many instances I never get a hold of them as they are busy in clinic or doing consults. I place the consult and *why* and then that's it.
I think this is very physician dependent. I use to call people all the time on consults and what the particular question that I wanted answered, but lately it is just not feasible since I am so busy. I don't think physician noncommunication is something unique to community hospitals, but more often seen where there are no residents. When I taught residents we always stressed the importance of communication with consultants-- but that's an ideal. I now don't have time to wait around for a consultant to call me back and many times they don't. If it something acute or a particular question that I have then I do try my best effort to get a hold of them.
In our office- if a physician calls, our staff will pull us out of the room to get us, but in other offices I can't get a hold of a consultant for the life of me! They will not page them or get them on the phone- sometimes they want me to talk to their PA, RN, NP, or resident-- which I think is stupid since I am an attending who wants to talk to the attending who is responsible for my pt. With that being said the times that I have gotten a hold of a physician the transition is so much smoother for both of us-- my question gets answered and the consultant knows why I sent the patient and what to look for.
No offense, Annie 501, but I have never been able to get a hold of a psychiatrist unless I see them in the hospital halls or parking lot--- I have called & paged many psychiatrists' offices and it is impossible to get a hold of them- their staff makes sure that there is a fortress around them. Many times I just end up texting my med school friends who are psychiatrists asking them what they think. It's really sad because in the end it's patient care that is being affected-- talking to a physician for 20 secs will give you a better picture than the hours talking to staff, patient, etc.
I am starting to think that going with the current system, meanwhile letting everyone know that I am available by cell as often as I can be and returning pages promptly, is probably the best way not to rock the boat.
English, that is a good point about not being able to get ahold of psychiatrists. I have been a psych resident for the last 4 years, and if I ever needed to talk to an attending during that time, I had better physically go find them. Anything else was pretty useless. I have been really surprised at how easy it is to get ahold of FP's and internists here in clinic. I feel kind of guilty about calling and pulling anyone out of a patient room. However, I agree that talking to the consulting physican for 20 seconds saves a lot of time, presents a better picture to the patient and family, and ultimately results in better patient care.