[Curbside consultation: another healthcare activity of the infectious disease specialist]

"Curbside consultation" is the term used to describe an informal process in which a physician requests information from another physician about the management of a patient who has not been assessed by the person consulted.

Prospective, observational study designed to determine the frequency, services requested, and final result of curbside consultations made over the period of 3 March to 12 May 2008. The variables recorded included the means by which contact was made, the type of question, person requesting information, complexity of the subject, related subject, recommendations, and degree of follow-up and evolution of the consultation. The degree of difficulty was evaluated using the system of the American Collage of Physicians. Parametric and nonparametric statistical tests were used in the analysis.

A total of 208 consultations (1.13/day) were reported, lasting a median of 2 minutes. The most common reasons for consulting were selection of an antimicrobial agent (54.4%), evaluation of a diagnosis (10.5%), interpretation of microbiological data (9.6%), and a combination of reasons (27.4%). In 5.8% of cases, hospitalization was required to study and treat the infectious disease. A formal consultation was required in 27% of cases. Significant differences were found between staff physicians and medical residents and between medical and surgical departments.

Curbside consultations comprise an important part of healthcare activity in the Infectious Disease Department, although most requests are easily resolved and do not imply an excessive work burden. Nonetheless, when the consultation involves a difficult clinical case, the request is by a staff physician, and the surgery department is implicated, a significant amount of formal activity is generated.