Thread by @SKriegerMD

Even before @Dglaucomflecken created The Neurologist — a brilliant parody of how neurologists think we know better than everyone — we were working on a project examining just that…
We even cite him in the paper out now in #NeurologyEd @greenjounal!
tinyurl.com/4fys63hz 🧵

In this project we looked at what makes some neurology consults seem “inappropriate” — as @Dglaucomflecken has demonstrated, neurologists have some *particular* ideas about what other docs do and don’t know about neurology…
#NeuroTwitter

In this paper in #NeurologyEd @greenjournal we hypothesized that the perception of inappropriate consults comes down to two fallacies… 🤔
tinyurl.com/4fys63hz

Here’s what we call #dualfallacies:

Each specialist thinks
1. What they know is obvious — and should be common knowledge to other doctors.
-And-
2. What they don’t know is obscure — and somebody else’s issue to solve.
#MedEd
tinyurl.com/4fys63hz

These two fallacies make a consult request seem totally reasonable to the resident who calls it, and unnecessary and inappropriate to the resident who receives it. We studied this with residents at @MtSinaiNeuroRes and @DOMSinaiNYC using common consultation scenarios…

We found that #neuro and #medicine residents in both cohorts thought each other should know more neurology answers than they actually did… 🤔

We then conducted structured interviews to unpack reasons for perceived “consult inappropriateness.” Residents agreed that appropriate consults must pose a specific question and occur only after an initial investigation was performed…but that this rarely happens. 😬

Awareness of the dual fallacies can itself mitigate the issue — cognizance of what other specialties realistically do and don’t know can foster greater generosity of spirit and better interdisciplinary communication. 🤝

Our inappropriate consults project was a labor of love from my coauthors. @ren_jennifer is an @icahnmountsinai student and all others were med students when we started and are now residents & beyond! @MSHSneurology @Sinai_Emerg_Med

Two final things-
Here’s first author Charles Sanky (who is not on twitter) from @SinaiEM w/@Dglaucomflecken to tell him we cited him in this paper… 👍
tinyurl.com/4fys63hz

And lastly…
To maintain standards of decency, @greenjournal asked us to edit some language out of the direct quotes from our structured interviews with residents. 🤬
“Consults are called when we don’t want to think about it and just want to cover our [selves]…