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June 1983

The Consultation

Author Affiliations

Westport, Mass

Arch Surg. 1983;118(6):713. doi:10.1001/archsurg.1983.01390060035007

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A successful consultation begins with the referring physician's obligation to have the facts clearly in mind when making the first telephone call. He should know whether he wants telephone advice, a bedside visit, or treatment for his patient at the consultant's center.

If a bedside visit is decided on, the physician should have the chart and films reviewed and marked, the family on site, and any local consultants alerted. On arrival, the consultant interviews the physician, studies the data, and examines the patient in private. He can learn whether the patient is satisfied with the local care or wishes to be transferred. Next follows a frank discussion with the referring physician and then recommendations to the family. Finally, at the bedside, the consultant gives his opinion in simple, reassuring language. He must remember that the patient is terribly sick, perhaps mortally so and should not add to the patient's torment

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