A.J. Hale is an infectious diseases specialist, University of Vermont Medical Center, and assistant professor of medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont. J.A. Freed is a hematologist, Beth Israel Deaconess Medical Center, and instructor of medicine, Harvard Medical School, Boston, Massachusetts. W.K. Alston is director of infectious diseases, University of Vermont Medical Center, and professor of medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont. D.N. Ricotta is a hospitalist, Beth Israel Deaconess Medical Center, and instructor of medicine, Harvard Medical School, Boston, Massachusetts.
Acad Med. 2019 Jun;94(6):809-812. doi: 10.1097/ACM.0000000000002659.
Consultation amongst providers is a foundation of modern health care and one of the most frequent means of interdisciplinary communication. Accordingly, clear and efficient communication between providers and across medical specialties during consultation is essential to patient care and a collegial work environment. Traditionally, consultation requests are felt to require a clear question that falls within the purview of the consultant's expertise. However, this narrow constraint is often lacking in the real-world clinical environment and may in fact be detrimental to physician communication and patient care. In this Perspective, the authors propose an organizing framework of seven specific consultation types, which apply broadly across disciplines: ideal, obligatory, procedural, S.O.S., confirmatory, inappropriate, and curbside. The authors describe what factors define each type and the benefits and pitfalls of each. The proposed framework may help providers have more productive, efficient, and collegial conversations about patient care, which may facilitate improved work satisfaction and an enhanced learning environment.
医生间的会诊是现代医疗保健的基础之一，也是最常见的跨学科交流方式之一。因此，在会诊期间，医生之间的清晰、高效沟通对于患者护理和良好的协作工作环境至关重要。传统上，会诊请求被认为需要一个明确的问题，并且该问题属于顾问专家的专业领域。然而，这种狭隘的限制在现实临床环境中往往是缺失的，实际上可能不利于医生之间的沟通和患者护理。在这篇观点文章中，作者提出了一个组织框架，其中包含了七种特定的会诊类型，这些类型广泛适用于各个学科：理想型、强制性、程序性、紧急呼救型、确认型、不适当型和路边型。作者描述了每种类型的定义因素，以及每种类型的优点和缺点。所提出的框架可以帮助医生更有效地、更高效地、更有协作性地讨论患者护理问题，这可能有助于提高工作满意度和改善学习环境。
