Monday, November 11, 2013

Dealing with ED Consultants

Consultants are vital to the success of any Emergency department.  The ED group's personal and collective relationship dramatically impacts care, throughput, and the "bottom line" for the ED group and the hospital.

Treating consultants with respect and honesty will ingratiate you into their network, which encompasses 95% of the institution.  Lunchroom gossip will not just entail ED horror stories, but comments about the skill and efficiency of the ED.

Consultants can make or break the quality of care and the headache level of the ED.  The goal is to develop relationships:
  1. Do not be so "ED-centric".
  2. Be sensitive to their schedules and time.  Do not wait to notify them right after they've left the building or at dinnertime- a head-up call is always appreciated!
  3. Take their advice, if reasonable, though you may have a different opinion.  Medicine is still an art and there are many pathways to success.  Use mutually agreeable department protocols.  Changing policies and philosophies at 0300 hour will not win or make you any friends!
  4. Thank them for their input and help.
  5. Help the with ED logistics.
  6. No shouting matches in public.  Go outside and have a discussion!
  7. Learn about their interests and families.
  8. Go to the lunchroom and interact like a regular staff member even if you hate going.
  9. Visit their department meetings.
  10. Do not wake them up, unless it is necessary.  Night shifts, diurnal rhythms, surgical schedules take their toll over time.
  11. If there is a significant problem, respectively agree to disagree.  Have a pre-planned conflict resolution pathway.  Notify the proper people in a timely manner depending on the seriousness of the patients' condition.  Continue to observe and treat the patient appropriately.
The bottom-line is to do what is right for the patient and be their advocate- everything else can be resolved!

1 comment:

  1. I find saying to consultants "I could use your help" rather than "you need to...

    Also if having difficulty coming to agreement, try to get them to actually see the patient as it is very easy to blow off a patient through the phone.

    Try to follow-up on cases, most other docs think we don't care about patients after we have made dispo. builds a lot of future cred.

    Be a good ER doc. Nobody wants to help someone who doesn't know what they are talking about.

    Dr. Andrew Schare- St Vincent Medical Center Jax, FL