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September 9, 1998

Curbside Consultations and the Viaduct Effect

Author Affiliations

From the Department of Medicine, Northwestern University Medical School, Chicago, Ill.

JAMA. 1998;280(10):929-930. doi:10.1001/jama.280.10.929

GROUCHO: Here is a viaduct leading over to the mainland.

CHICO: Why a duck? Why no chicken?

GROUCHO: You try to cross over there a chicken, and you'll find out why a duck. It's deep water, that's viaduct.

From the Marx Brothers, The Cocoanuts , 1929

Among the survival skills of the busy clinician is the "curbside consultation," which can be defined as informally obtaining information or advice regarding a patient from another physician who has not directly examined the patient or reviewed the patient's record, and does not document any recommendations. Given how common this practice is, it is surprising how little medical literature there is on the subject. The 2 articles in this issue of THE JOURNAL, by Keating et al1 and by Kuo et al,2 help to fill in the picture considerably.