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We all take pride in trying to call in a good consult.  But sometimes you get that feeling.  You know the one.  The one that says, “I should really suck more at calling consults.”  You’re not the only one.  Here are some helpful tips to help make that consult downright annoying and make your consultant think, “Wow, you really suck.”

medical consults
“Wait, hold on, I have 5 more interesting consults for you”

When the consultant calls you, jump straight in without saying “Hello.

Don’t be nice and waste time with “Hello” and “How are you?”  Just jump straight into the story: “I’ve got this guy, don’t know what’s going on, but you need to see him.”  Don’t allow questions or interruptions.  Keep talking and talking then hang up.

Never provide key information like name, birth date, or medical record number.

Don’t make the consult too easy.  Give no information to identify the patient whatsoever: “I forgot her name or where she is, but you’ll figure it out.”  Or even better, give partial information: “His first name is John” or “She was born in October.”

Never ask a clinical question; stay brief and vague.

Tell the nephrologist the reason for consult is “kidneys.”  Tell the dermatologist the reason for consult is “skin.”

Call the consult, particularly a non-urgent one, at 5 AM.

Sleep is overrated so go nuts and interrupt away.  Rhetorically ask, “Did I wake you?”  If he or she agrees to see the consult, change your mind, retract the consult, and say you’ll call him or her back if you change your mind.

Change your mind and call the consult again at 4:55 PM on a Friday.

To a consultant, 4:55 PM is a time of hope, that the weekend is near.  Destroy that hope.

If the consultant asks if he or she can see the patient tomorrow, say “Absolutely not.”

The patient must be seen immediately.  Defend it with no reasoning or very inconsistent reasoning at best.

Say that “Its a really interesting case,” but follow through with nothing interesting.

Set a high level of expectation and follow through with extreme disappointment.  Tell the cardiologist you’re baffled by a patient’s hypertension despite the blood pressure being at goal off of any antihypertensive medications.

Never provide pertinent clinical details either.

Don’t be too obvious.  If you’re calling Infectious Diseases, never talk about fevers.  If you’re talking to Orthopedics, leave out the part about bones.

It is always best to batch consults in multiples of 5.

Never, ever call a consultant with just one consult.  Call with 5, 10, 15, or 20 consults at a time and make sure you mix them up and get confused.  Be proud; not only do you really and truly suck, but you’ve also achieved arch nemesis status.  Way to go!

Dr. 99 really sucked once and called an inpatient consult to a primary care physician to perform a stat, bedside well-check exam. 

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Dr. 99
First there was Dr. 01, the first robot physician, created to withstand toxic levels of burnout in an increasingly mechanistic and impossibly demanding healthcare field. Dr. 99 builds upon the advances of its ninety-eight predecessors by phasing out all human emotion, innovation, and creativity completely, and focusing solely on pre-programmed protocols and volume-based productivity. In its spare time, Dr. 99 enjoys writing for Gomerblog and listening to Taylor Swift.