Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IAPM > Consultations > Flashcards

Consultations Flashcards

1
Q
  • Refers to the main manifestation of a doctor-patient relationship wherein a doctor is sought out for health advice, diagnosis and treatment.
  • Also a type of service provided by a doctor/s or specialist/s whose opinion or advice regarding evaluation & management of a specific problem is requested by another health care provider or appropriate source.
A

CONSULTATION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Main Purposes of Consultation:

A
  1. Recommend care for a specific condition or problem (interaction between a doctor and patient)
  2. Determine whether to accept responsibility for ongoing management of the patient’s overall care or for the care of a specific condition or problem (interaction between a doctor and consultant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Reasons for Consultation:

A
  1. Helping another doctor
  2. Second opinion has been requested by the primary doctor
  3. Second opinion has been requested by the patient
  4. Second opinion has been requested by a third-party payer
  5. Other third parties
  6. Disgruntled patient or family
  7. Inappropriate consultations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Occurs when a patient with a chronic condition is admitted to a hospital for an acute problem wherein it is usually assumed that the chronic condition is being managed by other doctors, because it is considered inappropriate for a consultant to request for another consultation on a different problem for a patient who is not directly under their management

A

INSTITUTIONAL ELITISM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Once a patient is admitted in a hospital, each and every system or organ that is abnormal is immediately consulted on by experts including those that focus on problems that are irrelevant to the current clinical setting.

A

CHURNING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

I. General Principles of Consultation
Refers to the reason the consultation was needed and requires direct communication to minimize the potential for any misunderstandings between the consultant and the referring doctor

A

DETERMINE THE QUESTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

I. General Principles of Consultation
A consultant must determine whether the consultation is emergent, urgent, or elective/routine.

A

ESTABLISH URGENCY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

I. General Principles of Consultation
Pertains to the consultant’s need to obtain independent historical, laboratory, and physical examination data and not only rely on the assessment of data that are already included in the medical record.

A

LOOK FOR YOURSELF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

I. General Principles of Consultation
Consultation notes in a patient’s medical record should not repeat in full detail the data that was already recorded by the primary doctor.

A

BE AS BRIEF AS APPROPRIATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

I. General Principles of Consultation
Consultation notes should be goal-oriented and expressed succinctly

A

BE SPECIFIC AND CONCISE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

I. General Principles of Consultation
Supplying alternative options for potential problems are necessary since a patient’s status is dynamic and the initial recommendation may prove to be irrelevant 24 hours after they were made.

A

PROVIDE CONTINGENCY PLANS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

I. General Principles of Consultation
A consultant must maintain a subsidiary role even if he/she has a responsibility to the patient since that responsibility should not be expressed through arguments or discussion with the primary doctor which may be interpreted as competing for the attention or loyalty of the px

A

HONOR YOUR TURF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

I. General Principles of Consultation
Consultants must make an extra effort to share their knowledge and expertise without condescension as this reflects negatively in the relationship between the consultant and the referring doctor

A

TEACH WITH TACT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

I. General Principles of Consultation
Direct personal contact with the primary doctor after a consultation is best, especially for recommendations that may be crucial or controversial

A

TALK IS CHEAP AND EFFECTIVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

I. General Principles of Consultation
Once the consultation notes have been completed and signed, he/she may review the medical record/chart to be sure that crucial recommendations have been acted on, and that important orders have been carried out

A

FOLLOW-UP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

II. Ethical Principles of Consultation
1. Pertaining to the role of the referring doctor

A

A. Consultations are indicated upon request for doubtful of difficult cases, or when it will enhance the quality of care
B. Consultations are primarily for the patient’s benefit
C. A case summary should be sent to the consultant, unless a verbal description of the case has already been given to the consultant

17
Q

II. Ethical Principles of Consultation
2. Pertaining to the role of the consultant

A

A. One doctor should be in charge of the patient’s care
B. The attending doctor has overall responsibility for the patient’s care
C. The consultant must not assume primary care of the px without consent from the referring doctor
D. The consultation should be done punctually
E. Discussions during the consultation must be done with the referring doctor and the patient only after prior consent has been granted by the referring doctor
F. If conflicts of opinion with the referring doctor have not been resolved by the second consultation, the consultant may withdraw from the case. But the consultant has the right to give opinion to the px in the presence of the referring doctor

18
Q

Breaking Bad News to a Patient:
SPIKES Protocol

A
  1. Settings
  2. Perception
  3. Invitation
  4. Knowledge
  5. Emotions
  6. Strategize and summary
  • most widely used
19
Q

Breaking Bad News to a Patient:
ABCDE Model

A
  1. Advance preparation
  2. Build a therapeutic environment/relationship
  3. Communicate well
  4. Deal with patient’s and family’s reactions
  5. Encourage and validate emotions / Evaluate the news
20
Q

Breaking Bad News to a Patient:
BREAKS Approach

A
  1. Background
  2. Rapport
  3. Explore
  4. Announce
  5. Kindling
  6. Summarize
21
Q

Breaking Bad News to a Patient:
Kaye’s approach (10 steps)
PWIGA ELESO

A
  1. Preparation
  2. What does the patient know?
  3. Is more information wanted?
  4. Give a warning shot
  5. Allow denial
  6. Explain if requested
  7. Listen to the patient’s concerns
  8. Encourage validation of feelings
  9. Summarize and plan
  10. Offer availability
22
Q

What is medical consult?

A

Procedure wherein the doctor reviews the patient’s medical history, performs a physical examination, and makes a recommendation regarding the patient’s care and treatment upon the request of another health care provider.

23
Q

What is medical clearance?

A

Signed authorization from a doctor requested by another health care provider in order to determine whether the proposed treatment/activity would affect the px’s condition or if the px’s condition could affect the proposed treatment/activity.

24
Q

What is medical certificate?

A

Signed document from a doctor which may be requested by a px or an employer which attest the result of a medical examination or serve as proof of an illness, injury, of the healthy condition of a px.

25
Q

Common reasons Dentists consult with the Patient’s Physician:

A
  1. Written consultation letter to request for physical evaluation and treatment of a px when signs and symptoms of a systemic disease is discovered in the dental clinic
  2. Request for additional information regarding the px’s condition or any clarification of the px’s current physical status
  3. Input and advice from the physician to help determine whether providing dental treatment for the patient would be a prudent course of action
26
Q

Types of Patients who may need Medical Consultation for Dental Treatment:

A
  1. Px who has high risk for the development of particular medical problems
  2. Px in whom abnormalities are detected during history taking, physical examination, or laboratory tests of which the px is not aware
  3. Px for whom additional medical information is required that may impact the provision of dental care or assist in the diagnosis of an orofacial problem
  4. Px with known medical problems who is scheduled for either inpatient or outpatient dental treatment and cannot adequately describe all their medical problems
27
Q

Classifications/Levels of Consultation:
I. According to Time

A

Level A - brief consultation that lasts <10 minutes
Level B - standard consultation that lasts 10 - 20 minutes
Level C - long consultation that lasts 20 - 40 minutes
Level D - prolonged consultation that lasts >40 minutes

28
Q

Categories of Time:
- for office and outpatient visits
- the doctor personally meets the patient and his/her family

A

Face-to-face

29
Q

Categories of Time:
- for hospital observation services, inpatient hospital care, initial and follow-up hospital consultations, and nursing facility services
- the doctor is present on the patient’s hospital floor/unit providing bedside services to the patient

A

Floor/Unit time

30
Q

Categories of Time:
- for inpatient hospital pre-encounter and post-encounter time, obtaining records and test results, and arranging for additional services
- the doctor does not work related to the patient before or after face-to-face time or floor/unit time

A

Non face-to-face time

31
Q

Classifications/Levels of Consultation:
II. According to Severity of the Problem/Condition

A

Level 1 - minor or self-limiting problems requiring counseling, treatment, and coordination of care with other health care providers
Level 2 - presenting problems are of low severity
Level 3 - presenting problems are of moderate severity
Level 4 - presenting problems are of moderate to high severity
Level 5 - major or complex medical problems requiring comprehensive evaluation

32
Q

Classifications/Levels of Consultation:
III. According to Clinical Responsibility
- Examination of the px’s medical record that may include diagnostic or therapeutic tests where the findings and recommendations of the consultant are recorded in the medical record after written report id provided to the referring doctor.
- Subsequent care of px continues to be the sole responsibility of the referring doctor.

A

SINGLE-VISIT CONSULTATIONS

33
Q

Classifications/Levels of Consultation:
III. According to Clinical Responsibility
- The consultant provides ongoing care in conjunction with the referring doctor.
- Consultant resumes at least partial responsibility for the px’s care.

A

CONTINUING COLLABORATIVE CARE

34
Q

Classifications/Levels of Consultation:
III. According to Clinical Responsibility
- Responsibility for the px’s care is transferred to the consultant wherein they are in charge of management problems that is outside the scope of the referring doctor’s education, training, and experience.
- In cases where px must be transferred to another health care facility.

A

TRANSFER OF PRIMARY CLINICAL RESPONSIBILITY

35
Q

Outcomes of Consultation:

A
  1. Total agreement
  2. Supporting consultation
  3. Finding another doctor for the patient
  4. Consultant assumes primary care of the px
  5. Serious troubles
  6. Redirecting the thrust of a workup
  7. Major disagreements between doctors
  8. Duration of consultation
  9. Non-compliant pxs
  10. End-of-life issues
  11. Family members of a health care provider
  12. When a diagnosis is not forthcoming
36
Q

Common Consultation Models:

A
  1. Hospital/Medical Model
  2. Pendleton et.al. Framework/Model
  3. Neighbor (The Inner Consultation)
  4. Calgary-Cambridge Observation Guide (Kurtz & Silverman Model)
  5. Stott & Davis Model
  6. Helman’s Folk or Anthropological Model
  7. The Disease-Illness Model
37
Q

Fundamental traits clinicians must possess for effective consultation:
AFTER CHC

A
  1. Aware of cultural competency / cultural sensitivity
  2. Frank
  3. Thorough
  4. Emphatic
  5. Respectful
  6. Confident
  7. Humane
  8. Caring

IAPM (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions