12 ways to prepare for a consultation

Because of busy schedules, answering machines and voice mail, contacting consultants for advice can be a test of your patience and persistence. The reverse is also true. Returning calls for consultation to busy colleagues in practice often requires persistence. However, persistence without proper planning often results in inefficient use of time, unfulfilled expectations and frustration for all concerned.

What can you do to enhance the benefits of phone consultations with specialists? The following suggestions are derived from my perspectives as a university faculty member who does not request monetary remuneration for consultation or for the expenses incurred when returning phone calls to my colleagues. I recognize that the context of my thoughts may not represent the needs or concerns of those of you who request consultations. However, I'm confident that putting the following suggestions into practice will enhance the ability and desire of consultants to assist you in further defining and solving problems. Many of these suggestions also apply to requests for e-mail consultations. All of these suggestions are based on the principle of the Golden Rule: Do for others what you want them to do for you.

1 Develop a plan before you make your phone call or prepare your e-mail. Before calling a consultant, organize your thoughts on paper, summarizing the points you want to cover and the specific questions you want to ask. Recall that a well-defined problem is half-solved.

2 Organize your patient's medical record to permit quick retrieval of information. Before you call, review the record with the goal of efficiently and accurately conveying the patient's updated problem list. Having immediate access to the record specifics also will help you accurately and efficiently answer questions the consultant may have.

3 Ask the consultant if it's a convenient time—especially if more than a few minutes are required. Asking this question conveys to the consultant that you respect his or her time. Also, the quality of the consultation is often linked to the time the consultant has available for discussion. If the consultant is preoccupied with other commitments, it may be wise to choose a different time to discuss your needs.

4 Don't keep the consultant waiting while your receptionist tracks you down. If the receptionist has to track you down, you're telling the consultant that his or her time isn't as valuable as yours. Whenever possible, place the call to the consultant yourself, especially if you're using the phone number to his or her personal office.

5 Be specific. Describe the exact laboratory values and other relevant diagnostic information—don't state that they're normal or abnormal. The specific results are observations; stating that they're normal or abnormal is an interpretation.

6 When phoning for advice, practice being a good listener. After summarizing your request for advice, give the consultant time to respond to your questions without frequently interrupting. There will be opportunities for you to clarify various points during the subsequent discussion. If it becomes apparent that errors by commission or omission may have occurred, avoid the urge to respond with defensive intent.

7 Don't impose by saying "While I have you, I want to discuss three other cases." If you need additional help with other patients, ask when the consultant will be available to discuss the cases.

8 Think twice before you ask for easily retrievable information. Don't use the consultant as a private tutor to explain common and well-documented disorders affecting your patient. If you don't have ready access to up-to-date information about problems that are described in the literature, consider asking the consultant to refer you to relevant information in journal articles, textbooks, or Web sites.

9 Use proper etiquette when leaving a message. At dictation speed and clarity, spell your name, briefly state your specific request for information and provide your phone number and the specific days and times you'll be available. Include a realistic assessment of the urgency of the problem in context to your patient's needs.

10 Don't ask the consultant to return your call unless you have voicemail or a specific time you'll be available. Consultants are frustrated when they return calls and are forced to listen to lengthy recorded messages with no option to leave a specific message for you. If you don't have voicemail but choose to leave a message for the consultant, be specific about the times you'll answer the phone.

11 Show respect for the consultant's time. Immediately after leaving a request for the consultant to return your call, alert your receptionist that you have requested a return call from the doctor and to immediately contact you when he or she calls. It's also reassuring to the consultant when your receptionist states that you're waiting for this return call. If you're unavailable when the consultant returns your call, indicate that you'll return the call or give him or her the opportunity to stay on the line by specifying when you'll be available. Do not expect the consultant to wait for you to come to the phone for more than two minutes.

12 Don't provide a consultant's personal office phone number or e-mail address to clients unless you have permission to do so. Concerned and frustrated clients often are ill-prepared to state the specific nature of the patient's problems and may be unable to understand the consultant's recommendations. If you've decided that there is need for consultation, contact the consultant yourself.

Epilogue

Every person's time is finite — and valuable. Investing your time in advance preparation for a consultation shows that you've considered both your colleague's well-being as well as your patient's. If you're well-prepared, your consultant will want to help you serve the needs of your patient and client. In addition, your investment will help to create a relationship between you and your consultant that will in turn facilitate his or her responsiveness to your future requests for consultation.

Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.

For a complete list of articles by Dr. Osborne, visit dvm360.com/Osborne.