The infectious disease consultant and the telephone consultation

The details of 105 telephone consultations made by 62 community physicians to a subspecialist in Pediatric Infectious Disease were prospectively evaluated. Of physicians seeking consultation 95% were pediatricians. Only one inquiry did not concern the immediate management of a patient. Sixty percent of inquiring physicians were consultants to primary physicians. Of 104 patients 51% were ambulatory and 49% were hospitalized. Most questions concerned topics that were commonly encountered in practice and not newly described illnesses or therapies. The primary basis of the consultant's advice was a larger experience with similar problems rather than convenient access to the literature. The telephone consultation is an effective educational tool for the community physician; it appears to be a barometer of the types of problems confronting the practicing physician and vignettes based upon such consultations may be an effective approach for continuing medical education courses.