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March 10, 1999

Curbside Consultation and Malpractice Policies—Reply

JAMA. 1999;281(10):899. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-10-jac90000

In Reply: We did not collect information about how insurance company policies might influence how physicians practice or feel about curbsiding. We feel it is unfortunate that Dr Block's malpractice insurer has chosen to prohibit curbside consultations because of the potential liability. One of the main findings of our study was the disagreement between primary care physicians and subspecialists about the quality of information exchanged in curbside consultations. However, we also established that curbside consultations are perceived to be an important method of communication between physicians that may have certain advantages such as saving time. It remains to be shown whether curbside consultations result in more adverse outcomes compared with formal consultations. Until such data become available, we believe physicians should continue to "curbside" each other. Rather than implementing broad policies against curbsiding, insurance companies and other institutions might consider providing guidelines for the proper utilization of curbside consultations. We hope that our findings will help improve this important element of medical practice.