There is no right way to complete a phone consult. Each physician will find a different way that works best for them, depending on their practice type and workflows.
Here are a few best practices we have heard from other Virtual Hallway physicians:
For your consult, you will need to focus and think through cases. If you are able, 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 Bluetooth device, as these can often reduce background noise during calls. Some physicians find that doing consults in the car on the drive home (using hands free Bluetooth, of course) is a nice way to focus on these calls.
Take a moment before the call to review the consult request to refresh your memory about the consult. Also consider having the patient’s chart available in case there is relevant information to draw from during the phone call.
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. Primary care practitioners will also ask lots of questions to ensure they understand the specialist's questions and recommendations.
Many times, a second consult will be needed. This might be because something was overlooked during the first consult. It could be that the patient’s condition has evolved or new information has come to light. Or perhaps, the recommendations were clinically sound, but just didn’t work for the patient and other options need to be explored.
We suggest that if possible, re-consults happen after 14 days since many billing regions do not allow reimbursement for calls that occur more frequently than 14 days for a given patient to a given specialty.
