Kuo D, Gifford D R, Stein M D
Department of Medicine, Brown University, Providence, RI, USA.
JAMA. 1998 Sep 9;280(10):905-9. doi: 10.1001/jama.280.10.905.
Informal (curbside) consultations are an integral part of medical culture and may be of great value to patients and primary care physicians. However, little is known about physicians' behavior or attitudes toward curbside consultation.
To describe and compare curbside consultation practices and attitudes among primary care physicians and medical subspecialists.
Survey mailed in June 1997.
Of 286 primary care physicians and 252 subspecialists practicing in Rhode Island, 213 primary care physicians and 200 subspecialists responded (response rate, 76.8%).
Self-reported practices of, reasons for, and attitudes about curbside consultation.
Of primary care physicians, 70.4% (150/213) and 87.5% (175/200) of subspecialists reported participating in at least 1 curbside consultation during the previous week. In the previous week, primary care physicians obtained 3.2 curbside consultations, whereas subspecialists received 3.6 requests for curbside consultations. Subspecialties most frequently involved in curbside consultations were cardiology, gastroenterology, and infectious diseases; subspecialties that were requested to provide curbside consultations more often than they were formally consulted were endocrinology, infectious diseases, and rheumatology. Curbside consultations were most often used to select appropriate diagnostic tests and treatment plans and to determine the need for formal consultation. Subspecialists perceived more often than primary care physicians that information communicated in curbside consultations was insufficient (80.2% vs 49.8%; P<.001) and that important clinical detail was not described (77.6% vs 43.5%; P<.001). More subspecialists than primary care physicians felt that curbside consultations were essential for maintaining good relationships with other physicians (77.2% vs 38.6%; P<.001).
Curbside consultation serves important functions in the practice of medicine. Despite the widespread use of curbside consultation, disagreement exists between primary care physicians and subspecialists as to the role of curbside consultation and the quality of the information exchanged.
非正式（路边）会诊是医学文化的一个组成部分，可能对患者和基层医疗医生具有重要价值。然而，对于医生在路边会诊方面的行为或态度却知之甚少。
描述并比较基层医疗医生和医学亚专科医生的路边会诊做法及态度。
1997年6月邮寄的调查问卷。
在罗德岛执业的286名基层医疗医生和252名亚专科医生中，213名基层医疗医生和200名亚专科医生回复了问卷（回复率为76.8%）。
自我报告的路边会诊做法、原因及态度。
基层医疗医生中有70.4%（150/213），亚专科医生中有87.5%（175/200）报告在前一周至少参与了1次路边会诊。在前一周，基层医疗医生进行了3.2次路边会诊，而亚专科医生收到了3.6次路边会诊请求。参与路边会诊最频繁的亚专科是心脏病学、胃肠病学和传染病学；被要求提供路边会诊的频率高于正式会诊的亚专科是内分泌学、传染病学和风湿病学。路边会诊最常被用于选择合适的诊断检查和治疗方案以及确定正式会诊的必要性。亚专科医生比基层医疗医生更常认为路边会诊中传达的信息不足（80.2%对49.8%；P<0.001），且重要的临床细节未被描述（77.6%对43.5%；P<0.001）。比亚专科医生更多的基层医疗医生认为路边会诊对于与其他医生维持良好关系至关重要（77.2%对38.6%；P<0.001）。
路边会诊在医疗实践中发挥着重要作用。尽管路边会诊被广泛使用，但基层医疗医生和亚专科医生在路边会诊的作用以及所交换信息的质量方面存在分歧。
