There is no right way to do a phone consult. Each physician will find a different way that works best for them, depending on their practice type and workflows.
In speaking with Virtual Hallway physicians, we have a few best practices for phone consults:
Being able to focus, and think through cases is ideal. If you are able to, find a quiet place, at a desk with the door shut. Ensure that you have a good phone line with good reception. This removes distractions that can reduce the effectiveness of the calls. If you are on the go, consider using an ear bud type blue tooth device, as these can often reduce background noise during calls. Some specialists find that doing consults in the car on the drive home (using hands free bluetooth, of course) is a nice quiet way to focus on these calls.
Take a moment before the call to review the consult request. With information from the request, specialists can focus on further questions they might want to understand about the patient. If needed, have the patient’s chart open nearby in case there are questions about the patient’s past medical history.
Some specialists keep their portal open and type their recommendations in during the call. This not only saves time, but also improves accuracy of the documentation as comptemporaneous documentation has been shown to be most accurate.
Consults are more about questions than they are about answers. No one will know everything and the more questions we ask, the closer we get to a mutual understanding about the patient. Specialists will ask lots of questions to ensure they have a clear picture about the patient. Family doctors will ask lots of questions to ensure they understand the specialists questions and suggestions.
Many times, we will need a second consult. This might be because during the first consult something was overlooked. It might be because the patient’s condition has evolved or new information has come to light. Or perhaps the recommendations, while clinically sound, just didn’t work for the patient and other options need to be looked at.
We suggest that if possible re-consults wait 14 days as many billing regions do not allow reimbursement of calls that occur more frequently than 14 days for a given patient to a given speciality.
