The first time you call a consultant is definitely terrifying. You may have heard a senior do it, but how to remain calm when an attending from another specialty is interrupting to ask “What’s the consult for?!” followed by firing a barrage of questions you don’t know the answer to?

The trick is to get ready before you pick up the phone! And we have THREE methods to do so. First, our own “prep first” method, one based on an EM study and finally one based on an IM study. Lots of options to ensure your first call to a consultant goes smooth.

Prepare before you call

  • Write down your one liner before you call, so you get it perfect on the phone. The consultant won’t know, but you’ll sound confident.
  • Write down the exact question you have for the consultant before you call. Read it to your senior resident or attending, so they can be sure to tweak it.
  • Think of questions that consultant may ask. If you can’t think of anything, ask your senior. They always ask something.
  • If you are calling about a specific patient it IS a consult, and the order should be placed just prior to or during the call.
    • In many systems consultants have expectations to meet about time of creating their note and seeing a patient versus your order time.
    • NEVER place a consult order at 5pm and call the consultant the next day!

Basic Tips

  1. Introduction – Who you are and what service you’re on.
  2. Patient – tell them who the patient is, ask if they’d like an MRN
  3. One Liner – Give a 1-2 sentence HPI without taking a breath, so you can get to #4 quickly.
  4. The Consult – Why you’re calling and consulting, the specific and precise question you are asking their service to answer

Five C’s of Calling a Consult Method

Developed by Emergency Medicine (our siblings, fellow generalists, and also frequent callers-of-consults) this format was developed and published in SAEM in 2012. The short version is listed here, but see the resources below for a link to the study itself, and details.

  1. Contact
  2. Communicate
  3. Core question
  4. Collaboration
  5. Closing the Loop

The Courteous CONSULT Mnemonic

From our cousins in Internal Medicine, published in the 2015 Journal of Graduate Medical Education, comes a mnemonic that’s a bit more narrative, using the world CONSULT. Again, I’m listing the mnemonic only; you can see the details in the resources below.

  • Contact the Consultant Courteously
  • Orient
  • Narrow Question
  • Story
  • Urgency
  • Later
  • Thank you!

That’s all the tips I have for you today. Hope it helps you confidently consult in the future. Keep learning, doctors.

Keep learning, doctors - Pixie

Resources:

  1. A prospective, randomized, controlled study demonstrating a novel, effective model of transfer of care between physicians: the 5 Cs of consultation. (Actual paper here.)
  2. NEJM Resident 360: How Do I Call a Successful Consult?
  3. The Courteous Consult: A CONSULT Card and Training to Improve Resident Consults
  4. BUMC Department of Family and Community Medicine Residency Programs, Inpatient Handbook, 2018-2019. Edited by S. Aldulaimi and P. Sanders, prior editions by S. Aldulaimi and V. McCurry.
How to Call a Consult

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