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Competency 5. Act in a consultative role to other physicians and health professionals

      The medical consultation is not a straightforward procedure, and the effectiveness of such consultations is not easily studied in a randomized controlled trial.
      • Lee T.
      Proving and improving the value of consultations.
      It is, however, a common intervention in patient care, and nearly all medical professionals request or provide consultative services as part of their clinical work. As with many other competencies and subcompetencies, there is significant overlap in the skill sets that are required. For consultation skills in particular, specific expertise is required in the domains of medical knowledge and patient care. Certain specific aspects of professionalism are also critical and have been the subject of much ethical and medicolegal debate as they relate to consultation.
      • Cohn S.
      The role of the medical consultant.
      The American Medical Association
      • Opinions and reports of the Judicial Council
      noted 9 ethical principles directly pertaining to physician consultation, 3 of which apply to the referring physician; the remaining 6 focus on the consultant. These serve to clarify the responsibilities and role of the consultant and are summarized briefly as follows: 1) one physician should direct the patient's care and treatment, and the consultant should not take on primary management without the consent of that primary provider; 2) the consultation should be done in a timely manner, the results should be communicated directly to the referring provider, and the results should be shared with the patient only by prior consent of that provider; and 3) differences of opinion need to be resolved with a second consultation or withdrawal of the consultation, although the consultant has the right to discuss her opinion with the patient in the presence of the referring physician.
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