#EMconf: Shore Retreat! Tips for Discussions With Consultants and Patients

                                                                      Our residents!



Consultants and admitting physicians

  • Introduce yourself and thank them for calling you back so quickly (even if they didn't!)
  • Lead with the reason for the consult/admit
  • Summarize the points from the H&P and diagnostics that have led you to placing this consult/admission
  • If the other physician disagrees with the urgency of a consult or admission, remember you hold the trump card: you have seen and examined the patient i.e. "He just doesn't look good."
  • Keep the emphasis on the patient: don't make it about you and the other physician i.e. "I think this patient really needs your help"
  • Avoid "ordering" the consultant to do something. Nobody likes being told what to do! i.e. "You need to come in and dialyze this patient right now!"  ----> "I think this patient is going to die without dialysis."
  • If all else fails, remember EMTALA law requires an on-call consultant to come and evaluate the patient if the EM physician insists...do what is right for the patient!


                                                                    ECGs in the pool! A Cooper EM retreat tradition




Patients and family

  • Knock before entering the room
  • Introduce yourself and then acknowledge everyone else in the room i.e. "who is here with you today?" and thank them for coming in to be with the patient
  • Thank the patient for their patience waiting, even if it hasn't been that long: this may diffuse the patient's anger when there is a substantial wait
  • Sit down!
  • Allow family to give their information and express their concerns. Acknowledge their concerns and try to avoid discounting their ideas i.e. "I understand your concerns that your mother may have reflux, and you could be right about that, but I'm going to order some other testing to make sure she doesn't have anything else going on to make sure she is safe to go home."
  • Close with "what questions do you have for me" instead of "do you have any questions?"


       Dodgeball! Another Cooper retreat tradition (the PGY-2's were triumphant)