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A #tweetorial/#medthread on…

CONSULT ETIQUETTE – for the consultant!

(This is the 2nd in a series on consult etiquette. See the end of this thread for a link to my other tweetorial for primary teams calling consults).

#MedEd #FOAMEd #dermtwitter #medtwitter #dermatology
So you just got paged for a consult…. What do you do?

Of course we all think #1, yes?! Realistically though, it can be stressful to get consults. They are unpredictable, can come at any time, & the primary team may or may not listen to what you have to say. Here are some tips I’ve come up with from my time on #dermconsults.
1 – Be kind.

You may think the consult you just got is “lame” or “too basic.” Remember that the team is asking for help. What is simple to you may be confusing to them. Rather than complain, rejoice in the fact that you have expertise and can contribute to patient care!
2 – Be timely, or at least set expectations.

The sooner you can do the consult the better, but if you aren’t going to round until the end of the day, it helps to let the team know. Then they know when to expect recommendations & aren’t frustrated when you page them at 7 pm.
3 – Embrace your role as a consultant.

That means you’re not the primary team. They don’t have to take your recs (they are after all, “recommendations.” No need to get offended if they choose to do something different. I will, though, ask them why if it keeps happening.

4 – Talk to the team.

My favorite moments from consults is when I get to discuss recs in person so we can have an actual back and forth. If not that, at least via phone is nice to have a discussion. Dropping recs in a note may be efficient, but help build collaborative care.
5 – Play nice in the sandbox.

You are ambassadors for your specialty in the house of medicine. If you were mean to the intern or student that called you, you can bet they’re going to spread that far and wide. Soon, you AND your entire specialty will be known in that way.
6 – This one’s a subtle one. Instead of “Assessment and Plan,” write an “Impression and Recommendations.”

This ties in with the fact that your recommendations aren’t actually the plan, since you’re not the primary team. It helps to think this way when you write your note.

Nothing ruins your reputation more than this. Remember that you are an expert & they are asking for help. If something is better taken care of as an outpatient, have that discussion. But flat out saying you won’t see someone never goes over well.
So to recap:
1 – Be kind.
2 – Be timely, or at least set expectations.
3 – Embrace your role as a consultant.
4 – Talk to the team.
5 – Play nice in the sandbox.
6 – Write an “Impression and Recommendation.”
7 – Don’t block consults.
I hope this helps! If you haven’t yet, take a look at my other #tweetorial on consult etiquette from the other POV (the primary team)! And if you have other tips to share, drop them below!👇👇👇

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