Consultative General Internal Medicine for Complex Care: The Model, Outcomes, and Lessons Learned

As the landscape of modern medicine evolves, new health care delivery models are needed to meet the growing complexity of medical care. Primary care clinicians are increasingly managing patients with multiple chronic conditions, a challenge that will intensify as the population ages. Complex medical care involves multiple factors that contribute to difficulties in providing optimal quality of care for patients facing these types of medical problems. To address this need, models of consultative general internal medicine have emerged at various tertiary care institutions across the United States to synthesize prior evaluations, recommend appropriate testing and specialty consultations, and integrate findings into a cohesive care plan for implementation by patients' local care teams. Variability in expertise, patient volume, and structure exists across institutions, but the expansion of multidisciplinary care capabilities during the COVID-19 pandemic has created new opportunities for destination-type practices. This narrative review explores how consultative medicine will be crucial to providing integrative, patient-centric care by enhancing diagnostic accuracy, coordinating multidisciplinary input, and communicating actionable care plans to patients.