Health & Healthcare

The Curbside Consult

July 07, 2008 | By JC, MD | Bookmark and Share | 4 Comments

Health and Healthcare Category A physician frequently gets stopped in the hall of the hospital or gets paged by another doctor for an unofficial consult. In medicine, this is called a “curbside consult.” Essentially, one physician would like some input on a case without getting the consulting physician officially involved in the patient’s care. Typically, this is done because the primary physician either knows the answer already but wants to run it by someone else. Or because he thinks the problem is not major enough to warrant an official consult. If an official consult is requested it will require the consulting physician to see the patient, write a consultation note, as well as dictate a consultation note.

Pathway The concept of “curbside consult” often moves outside of the hospital and often involves friends and strangers consulting you for your expertise in an “unofficial” manner. Imagine going to a cocktail party and people finding out you are a pediatrician. A “friend’s” child has some odd symptoms and they want to know what you think about it and how you would go about treating it.

Most often a physician will ask who the child’s pediatrician is and recommend that they go see that person for the child’s care. If they are looking for a new pediatrician the doctor will probably tell the parent to call his office for an appointment.

Most often physicians do not like to do curbside consults for strangers or friends because they technically are not the patient’s doctor. There is no physician-patient relationship established. However, by giving a medical opinion, it could potentially be inferred that such a relationship was initiated. Thus, many physicians like to draw a clear line between interactions that denote a physician-patient relationship is intact versus interactions that are not.

I personally have been asked tons of times for medical advice on people who are not my patients. I am always honest and let the person know that if they are concerned they should see their own physician or go to the nearest emergency room. I do this not because of medical liability but also because I do not want to be responsible for any potentially adverse outcomes. These adverse outcomes end up being the “skeletons” in every physician’s closet.

Tags: care, child, Consult, consultation, consulting, Curbside, Doctor, hospital, medical liability, patient, pediatrician, physician, relationship, responsiblity, unofficial, unprofessional

4 Comments

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Ron
July 07, 2008 | Permalink

My brother in law is a GP and his way of dealing with unwanted consults is to pretend that he is not a very good doctor. You’ll often hear him saying things like, “Hmmm, not sure what that could be. I never did well in that part of the course.”

This same thing happens to lawyers and computer savy people (probably other professions as well). I once heard that a doctor complained to one of his lawyer friends about this very thing. The lawyer said, “The way I deal with it is I give the advice and then send the person a bill the next day.” The doctor thanked his friend for the advice and decided he would try it. A few days later though, he received a bill in the mail from his lawyer friend.

IT
July 10, 2008 | Permalink

Hi K,

The term “curbside consult” is familiar, in fact, I have read an article pretty similar in nature yours just a couple of years back. And during my stint at the Emergency Dept during a training module to do with legal aspects of medicine we did cover this as well. In short, don’t do it.

But (you know this is coming), I think there is another aspect about curbside consult that is not mentioned in the article. It is practically based on trust by both parties. The asker trusts the askee has the knowledge to give an opinion based on his expertise, while the askee trusts the asker will exercise his own judgement on when to seek more professional help and not to sue should anything untoward happens. It’s a given that curbside consult is an AOR (At Own Risk) endeavour. Or at least it is, among my circle of friends and acquintances. For added measure, I always remind them as well.

And yes, I do ask my lawyer, accountant, financial manager and software engineer friends for “curbside consults” too!

Just curious, won’t you give advice to your own mother or sister, should they ask for a medical opinion?

Barbara
July 23, 2008 | Permalink

Therapists are tapped for quick opinions also. I demur from many-a cocktail consultations by being a pediatric therapist. I consistently have told whoever asks that I can refer them to the best people I know for adult and orthopedic diagnoses.

Then there’s the people who love to tell how much PT hurt and the PT was a saddist. To which I ask, does your [body part] now work? Conversation ends.

gluck7104
August 25, 2008 | Permalink

Curbside…I had a doctor do that after I discovered that my parathyroid measurement was 171 at the age of 53. 20 years earlier they discovered that I had osteoporosis. This morons, I now am forced to go to, having NEVER seen him before in a curbside consult said that my parathyroid problem was secondary. It was primary, I had to leave my town to have that discovered. Arrogant demi gods. I writhed in pain and this lazy, sociopath,(who trains the resident doctors) cares more about his ego than a tortured, in pain mother of 5, who is deathly ill. Curbside fits thier treatment of me!!!! Isn’t that where you put your garbage? Curbside? I detest the unconscienable medical practice of the U.S. I am sitting here now with less than 29% total function of my kidneys, certain I have another kidney infection, knowing that when I go in, which I have to, that, the labs will either be incorrect or they will put me on the 4th medication this year, that will be toxic to my kidneys..ABSOLUTELY hoping to have me dead!!! Who is a murderer? I know!