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Consultative Medicine |
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| Goal & Educational Purpose |
As much as one
third of a general internist’s time may be spent in the role of
consultant. Although much of this activity has traditionally been centered
on care of hospitalized patients undergoing surgery, it also includes
outpatient preoperative evaluations and management in pregnant women and
in patients with psychiatric disease. As consultant, the internist
frequently has a central role in the overall management of the patient’s
medical care by coordinating subspecialists’ recommendations and assuring
long-term follow-up. General internists should have and appreciation of the body of knowledge that has developed in consultative medicine. Most important is an understanding of the physiologic response to surgery and anesthesia, disease-related and procedure-related risk, prophylactic therapy to prevent perioperative problems, and post-operative medical complications. The general internist should also sufficiently understand the physiology of pregnancy and the categories of psychiatric disease and its pharmacologic treatment to manage medical problems in these patients effectively. Given the broad nature of the consultative medicine, the range of competencies in medical consultative caries little among practice settings. However, the extent and complexity of the role may be determined by the availability of surgical, anesthesia, trauma/critical care, obstetric, psychiatry, and other specialist, including internal medicine specialists. Optimal consultative care requires skills that can be adapted to both office practice and a variety of hospital settings, including outpatient and day surgery. Since medical consultation is practiced at the interface of internal medicine and other specialists, it requires familiarity with those specialties, skill in synthesizing information, and appropriate effective communication with attending and other consulting physicians, dentists, other health care workers, and families. |
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| Reading List |
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West Virginia University | Robert C. Byrd Health Sciences Center (Morgantown) | West Virginia University Charleston Division | Internal Medicine