Utilization of a Novel Inter-Specialty Consultation Service with Dentistry: A Descriptive Cross-Sectional Study

Purpose: To describe utilization patterns and patient disposition of Physician Direct Connect (PDC), a peer support program enabling direct provider-to-provider consultations with dentistry at a major children's hospital. Methods: Data were collected from electronic medical records from 2009 to 2023 for all patients whose providers utilized the PDC service to communicate with a dentist and analyzed to determine utilization by patient demographics, provider type, primary dental concern, and disposition. Results: Of the 2,689 individual patient encounters identified, most consultation requests were placed by physicians (94.1%) and in an urgent care facility (67.7%). The consultation was typically resolved with advice (46.6%), with 23.9% requiring clinic follow-up and 28.7% requiring transfer to an emergency department (ED). Dental trauma was the primary dental concern (47.9%) and comprised 58.9% of the patients with ED transfer, followed by infection (22.8%), pain (14.4%), and developmental concerns (4.4%) as reasons for consultation. Consults were primarily for patients who were male (56.2%), White (49.7%), aged 12 or younger (86.4%), insured by Medicaid (50.6%), and preferred speaking English (83.9%). Conclusion: Provider consultation enhanced patient assessment and navigation, reduced unnecessary emergency department or clinic visits, and promoted health equity and cost savings, particularly among patients with Medicaid in urgent care settings.