The service and educational contributions of a general medicine consultation service

General medicine consultation services (GMCS) are perceived as providing routine services in perioperative patient management for referring surgeons. Their potential contributions to improving patient care and resident education have not been well defined. Review of the first year of GMCS in a university teaching hospital showed that only 57% of the consultations were for routine perioperative management of surgical patients. The consultations presented a broad range of medical problems, especially cardiovascular disease (35% of all consultations). Consulting physicians made 2.2 new diagnoses per consult, and 16% of patients required transfer to other services. A GMCS may improve patient care by uncovering new diagnoses, and, by offering them exposure to a variety of medical problems, can improve the consultation skills of students and residents.