July 1 marks the infamous, and important, milestone: brand new medical and surgical interns officially start their full-time clinical duties in hospitals across the nation.
Once the newly-minted physicians have had a chance to find their office, important wards/floors in the hospital, the nearest restroom, and hospital cafeteria, soon enough the new consults will start rolling in.
I found this to be an opportune time to quickly list just a couple important — dare I say vital — tips for new interns (and new second year residents) calling/ordering inpatient gastroenterology consults:
- Always include a specific question (or concern) in the ‘reason for consultation’ field. The infamous “?scope” is not sufficient. Much better is, “Rectal exam reveals melena, Hgb drop 3 grams compared to prior H&H just three months prior. Question need for upper endoscopy to rule out upper GI bleed.”
- Call or electronically enter your consult request as early in the morning as possible. This allows the consult fellow(s) to review the chart, see your patient, and give recommendations sooner. Furthermore, it helps the attending prioritize rounds/procedures which also helps facilitate timely recommendations.
- If there is concern that the patient will need an urgent (same day) scope, always make him/her NPO.
- Breathe — your GI fellow and/or attending should be there to teach, should you have any questions. Many situations are not so clear-cut, and will require further discussion (preferably over the telephone).
Photo by Tomas Sobek.