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General medicine consultation. Lessons from a clinical service
The American Journal of Medicine
|July 1, 1983
Summary
A general medicine consultation service defined its academic domain by analyzing 564 cases. Key areas included preoperative management of chronic illnesses and diagnostic issues in psychiatric patients, highlighting the service
Area of Science:
- General Medicine
- Academic Medicine
- Consultation Services
Background:
- A new general medicine consultation service was established to define its academic domain.
- The service aimed to provide specialized medical support across various hospital services.
Purpose of the Study:
- To operationally define the scope and function of a general medicine consultation service.
- To analyze consultation patterns and patient demographics.
- To gather data for future educational and research endeavors.
Main Methods:
- Retrospective analysis of 564 consultations over the first year.
- Categorization of consultations by referring service (surgical, psychiatric).
- Evaluation of service by referring physicians and residents.
Main Results:
- 52% of consultations were for surgical patients, primarily for preoperative chronic illness management (hypertension, diabetes, angina).
- 47% of consultations were for psychiatric patients, often for diagnostic issues (abdominal pain, dementia, thyroid disease).
- Referring physicians rated the service favorably, though some noted recommendations disproportionate to problem complexity.
Conclusions:
- The general medicine consultation service plays a significant role in managing complex patient cases, particularly in surgical and psychiatric settings.
- The service's educational impact was perceived as stronger in 'art' than 'science' of consultation.
- Findings provide an operational definition and data to guide future development of such services.