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Defining emergency physicians' consultative roles in emergency care: a scoping review
Joshua Cunningham1, Niklas Bobrovitz2,3, Ajaykumar Shanmugaraj1
1Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
CJEM
|November 3, 2025
Summary
Emergency physicians provide crucial consultation in emergency care, acting in real-time support, rapid response, and referral management. Advancing "consultative emergency medicine" can expand this expertise globally.
Area of Science:
- Emergency Medicine
- Health Systems Research
- Medical Consultation
Background:
- Emergency physicians possess a core responsibility for expert consultation in emergency medical care.
- The manifestation and potential expansion of their consultative roles within health systems are not well-defined.
Purpose of the Study:
- To identify, clarify, and map key concepts of emergency physicians functioning as consultants within health systems.
Main Methods:
- A comprehensive scoping review was conducted across multiple databases (MEDLINE, Embase, Cochrane, CINAHL) and grey literature.
- English-language articles with no date restrictions were screened by two independent reviewers.
- Data from included studies were synthesized using a narrative approach.
Main Results:
- 67 articles from 15 countries (1974-2023) were included after screening 8744 articles.
- Emergency physicians primarily served in three consulting roles: real-time support, rapid critical response, and direct referral management.
- Telemedicine was the most frequent consultation mode, followed by hospital protocol activation and emergency department referrals.
Conclusions:
- Emergency physicians fulfill diverse consultative roles within healthcare systems.
- Defined as "consultative emergency medicine," this competency involves advising on patient care or health services requiring rapid intervention.
- Enhancing "consultative emergency medicine" can extend emergency care expertise to other providers globally.
Keywords:
ConsultantsEmergency hospital servicesEmergency medical servicesHealth care systemsHospitalsReferral and consultationsMore Related Videos
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