A hospital consult is a standard procedure in inpatient medical care, representing a formal request for expert advice from one medical team to another. This internal communication mechanism is used by the patient’s primary medical team to gain the insight of a physician with advanced training in a specific area. The consult system ensures patients receive specialized and comprehensive care by bringing diverse medical expertise to the bedside.
What Defines a Hospital Consult
A hospital consult is a professional request for an opinion or recommendation on a specific problem for a patient already admitted to the hospital. The process involves two primary parties: the requesting physician or primary care team, which retains overall responsibility for the patient, and the consultant, who is the specialist providing the expert advice. The consultant’s role is to evaluate the patient’s condition and provide recommendations for diagnosis, testing, or management of a particular issue.
The advice given by the consultant is not an order, but a set of suggestions. This distinction is significant, as the primary team continues to coordinate the patient’s overall treatment plan and care trajectory. A consult is different from a transfer of care, where responsibility for the patient’s main condition is formally handed over to a new service. Unless there is a formal transfer, the consultant focuses on a defined, specific issue rather than assuming control of the patient’s entire hospital stay.
When and Why a Specialist is Requested
Consults are requested when the complexity of a patient’s case exceeds the primary team’s expertise or requires specialized procedures. Diagnostic uncertainty is common, where a patient presents with symptoms difficult to categorize, such as a persistent fever of unknown origin or an unusual neurological finding. In such cases, the primary team may request an infectious disease specialist or a neurologist to help confirm a rare or complex condition.
Another frequent reason for a consult is the management of complex comorbidities. For example, if a patient with severe heart failure needs an urgent surgical procedure, a cardiology consult would be requested to manage heart function during and after the operation. This co-management ensures that chronic conditions are safely handled alongside the acute problem. Consults are also necessary when specialized procedures are required, such as requesting an interventional radiologist for a minimally invasive biopsy or a neurosurgeon to evaluate a brain injury.
How the Consult Process Affects Patient Care
Once the primary team places a consult request, the consulting service begins the evaluation. The specialist first reviews the patient’s electronic medical record, including previous test results and the notes written by the primary team. They then perform their own physical examination and interview the patient, focusing specifically on the area of their expertise.
Following the evaluation, the consultant documents their findings and recommendations in a note, known as the “consult note.” This note outlines the specialist’s opinion, suggests further diagnostic testing, and recommends specific changes to the patient’s treatment plan, such as starting a new medication or scheduling a procedure. The primary care team then reviews these recommendations and decides which ones to incorporate, ensuring a coordinated and comprehensive approach to treatment.