Comments on: A Call For a New Model For Generalist-Specialist Information Exchange

By: ClHarvester

ClHarvester — Mon, 07 Jul 2014 15:03:26 +0000

There are simply some people who seem to take great pleasure in flagging ads
whether they are legitimate or not. This is a ideal area from where you can start your career as an attorney.
Another issue you will have to deal with when posting to Craigslist is other home business owners flagging your ads for no reason.

By: Dr.Redwanul.Huq

Dr.Redwanul.Huq — Fri, 03 May 2013 03:19:49 +0000

Exchanging information between generalist and specialist will definitely improve the knowledge and quality of both and also will benefit the patients.

By: Chieftb

Chieftb — Thu, 02 May 2013 02:01:27 +0000

I didn’t know curbside consults were coming under fire. In the best integrated care-world, all specialists would feel comfortable rendering opinions and this information would be synthesized by the treating physician. I’m from the “old” days when doctors did like discussing patient care and quick Q&A in the halls or even on the phone saved lots of $$ and benefited patients.

By: Eric Smith

Eric Smith — Tue, 30 Apr 2013 21:58:42 +0000

Very interesting article! When I began reading it I thought you were going to definitely recommend getting rid of curbside consults. Apparently I was wrong. But that conclusion kept me reading. However, you never mention what you would suggest as a creative solution? Do you have one in mind, or is that still in the works?

Thanks again for sharing.

By: David Bronson

David Bronson — Tue, 30 Apr 2013 17:00:04 +0000

Well said. At last, someone who understands nuance! When presented a case by a resident or student and asked for an opinion, I usually state, “Seeing the patient through your eyes, I would approach the problem this way. But if I see the patient, I often learn something new that changes my approach.” The same applies to curbside consults.

Last fall as ACP president, I convened a “summit” of the IM subspecialty society leadership including SHM, SGIM, and all the IM subspecialty societies. 63 attendees spent the day discussing how we could better work together to improve patient care and our profession. May ideas were brought forward, but the one achieving the strongest resonance was improving the generalist-specialist information exchange and care coordination. “Coordinating Care Wisely” was the term used that day (with a nod to the ABIM). A task force has been working on this theme and I hope a useful document and roadmap can be developed. The key desired outcomes are better patient care at the right cost, professional satisfaction and fair compensation for all professionals. Perhaps the ABIM Foundation would like to support this effort!

By: Shirie Leng, MD

Shirie Leng, MD — Tue, 30 Apr 2013 12:35:52 +0000

Dr. Wachter – Love the piece. Curbside consulting is a common way of communicating across medicine, business, banking and life in general. They just call it something else. It’s crucial for any business model. Companies like Google put everyone in the same room without offices for exactly this reason, so people can bounce ideas off each other and use each other’s expertise. One of the reasons I’m skeptical about online college degrees is much the same: the opportunity to be in the room with others to enlarge the greater knowledge is critical to learning.
The reason curbsiding it’s a problem for us seems to stem from litigation issues. The lawyers have sort of changed something good into a problem. Any good physician asks for advice from his expert colleagues. No good physician is going to base all his treatment solely on this advice, any more than Zuckerberg is going to base all his decisions exclusively on what Stanberg says. But the input is invaluable.

By: Kyle Samani

Kyle Samani — Tue, 30 Apr 2013 03:04:41 +0000

Dr Wachter

Excellent piece. I loved it. It reminds me about this piece from DirkMD about information hand off between specialists.

You’re absolutely correct. Monolithic, top down rules never accomodate the nuances of daily healthcare delivery. There are just too many exceptions.

http://dirkmd.blogspot.com/2012/02/could-new-note-football-help-improve.html