Consults, both formal and “quick questions” (curbside consults) occur throughout the day. When doing consults please use and refer to our guidelines whenever available and appropriate. We want to be consistent in our consult recommendations—so consult other pediatricians if the patient is not straightforward.
When an official consult is requested of peds make sure you are clear about what the consultation is for and that they have ordered a pediatric consult in RAVEN. If you are acting solely as the consulting physician, do not write orders on the patient unless specifically asked to do so by the primary provider. Family Practice providers may also ask unofficial “curbside” questions about a patient; this is fine if the question is straightforward. If the consult gets more complicated and requires a chart review please have the requesting doc turn the question into an official consult request. When performing a formal consult, write a consult history and physical-type note (for communication and billing purposes). Remember to complete a charge in RAVEN for any formal consults.
Occasionally it will become apparent that a patient is sick enough that the FM provider may request help with caring for the patient or ask us to take the patient care over for them.
One of the most common consults is evaluating murmurs in newborn, infants and older kids. If the murmur sounds benign and there are no other significant issues and it was just a quick listen then it can be treated as a curbside consult with reassurance. The consulting provider may document their quick consult and/or you can add a brief addendum to their note. If there is any concern or if further evaluation and/or follow up is required, then a note and a charge by the pediatrician need to be completed.
Pediatricians are consulted by inpatient, ER, Clinic and SRC providers as well as health aides and your fellow pediatricians. Consults can be for reassurance about a management and follow up plan, to help determine how sick a kid is, lab questions, or specific evaluation/management questions about jaundice, boils, pneumonia, fevers etc.