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Hospitalist Perspective of Interactions with Medicine Subspecialty Consult Services
Author(s) -
Adams Traci N.,
Bonsall Joanna,
Hunt Daniel,
Puig Alberto,
Richards Jeremy B.,
Yu Liyang,
McSparron Jakob I.,
Shah Nainesh,
Weissler Jonathan,
Miloslavsky Eli M.
Publication year - 2018
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.2882
Subject(s) - subspecialty , medicine , hospital medicine , family medicine , medline , perspective (graphical) , nursing , artificial intelligence , political science , computer science , law
BACKGROUND Medicine subspecialty consultation is becoming increasingly important in inpatient medicine. OBJECTIVE We conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation. DESIGN AND SETTING The survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States. MEASUREMENTS The survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist–fellow and hospitalist–subspecialty attending interactions. RESULTS One hundred twenty‐two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in‐person communication occurred during less than half of consultations, and 64.4% perceived pushback at least “sometimes” in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist–consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation. CONCLUSION The hospitalist–consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.