Open AccessInformal Consultations Provided to General Internists by the Gastroenterology Department of an HMO
Author(s) -
Pearson Steven D.,
Moreno Ricardo,
Trnka Yvona
Publication year - 1998
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.1998.00131.x
Subject(s) - medicine , workload , referral , family medicine , physician assistants , workforce , observational study , test (biology) , health maintenance , primary care , health care , nurse practitioners , paleontology , computer science , economics , biology , economic growth , operating system
OBJECTIVE: To study the process, outcomes, and time spent on informal consultations provided by gastroenterologists to the primary care general internists of an HMO. DESIGN: Observational study. SETTING: A large, urban staff‐model HMO. PATIENTS/PARTICIPANTS: Seven gastroenterologists constituting the total workforce of the gastroenterology department of the HMO. MEASUREMENTS AND MAIN RESULTS: Data on 91 informal consultations were obtained, of which 55 (60%) involved the acute management of a patient with new symptoms or test results, and 36 (40%) were for questions related to nonacute diagnostic test selection or medical therapy. Questions regarding patients previously unknown to the gastroenterology department accounted for 74 (81%) of the consultations. Formal referral was recommended in only 16 (22%) of these cases. As judged by the time data gathered on the 91 consultations, the gastroenterologists spent approximately 7.2 hours per week to provide informal consultation for the entire HMO. CONCLUSIONS: Gastroenterologists spend a significant amount of time providing informal consultation to their general internist colleagues in this HMO. The role informal consultation plays in the workload of physicians and in the clinical care of populations is an important question for health care system design, policy, and research.