Informal Consultations Provided to General Internists by the Gastroenterology Department of an HMO
Article first published online: 25 DEC 2001
1998 by the Society of General Internal Medicine
Journal of General Internal Medicine
Volume 13, Issue 7, pages 435–438, July 1998
How to Cite
Pearson, S. D., Moreno, R. and Trnka, Y. (1998), Informal Consultations Provided to General Internists by the Gastroenterology Department of an HMO. Journal of General Internal Medicine, 13: 435–438. doi: 10.1046/j.1525-1497.1998.00131.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- informal consultation;
- health maintenance organization (HMO);
- physician workload
To study the process, outcomes, and time spent on informal consultations provided by gastroenterologists to the primary care general internists of an HMO.
A large, urban staff-model HMO.
Seven gastroenterologists constituting the total workforce of the gastroenterology department of the HMO.
MEASUREMENTS AND MAIN RESULTS:
Data on 91 informal consultations were obtained, of which 55 (60%) involved the acute management of a patient with new symptoms or test results, and 36 (40%) were for questions related to nonacute diagnostic test selection or medical therapy. Questions regarding patients previously unknown to the gastroenterology department accounted for 74 (81%) of the consultations. Formal referral was recommended in only 16 (22%) of these cases. As judged by the time data gathered on the 91 consultations, the gastroenterologists spent approximately 7.2 hours per week to provide informal consultation for the entire HMO.
Gastroenterologists spend a significant amount of time providing informal consultation to their general internist colleagues in this HMO. The role informal consultation plays in the workload of physicians and in the clinical care of populations is an important question for health care system design, policy, and research.