Abstract
Introduction
Informal (hallway) medical consultation is an integral part of the physician’s work. As musculoskeletal complaints are very common, orthopedic surgeons stand in the frontline of this practice. Many of these consultations are poorly, if at all, documented, thus imposing a potential medical danger to the patient and a medicolegal danger to the surgeon. We conducted this first study to examine whether this practice is common among the orthopedic surgeons in university hospital.
Methods
In this prospective study, a 2-month record of informal consultations was kept. Six orthopedic surgeons—two joint reconstruction surgeons, one spine surgeon, two arthroscopy and sports medicine surgeons, and a shoulder surgeon participated. They recorded the details of the consulter, whether the consultation was for himself or somebody else, the major complaint, and whether it was a second opinion. All patients were advised to go to the formal orthopedic consultation and no advice or treatment was given. At the end of 2 months, each surgeon was asked to evaluate the percentage of cases he had failed to report.
Results
During the 2-month period, 158 people asked for informal (hallway) consultations. 11 of them (7%) were physicians, 114 (72%) were other hospital personnel, 26 (17%) were unrelated to hospital, and 6 (4%) were treated patients’ relatives. 93 (59%) of consultations were about the consulter himself and the rest were about a relative or a friend. 41 (26%) were requests for a second opinion. The estimated percentage of not reported cases was 10–40%; when the number of consultations was corrected for these figures, it reached 208 consultations in 2 months.
Discussion
In this prospective study, six participating surgeons recorded 158 informal consultation requests in 2 months. If a correction is performed, it averages 0.6 consultations a day for a surgeon (or, if only workdays are counted—0.8 consultations a day). Orthopedic surgeons should be aware of this frequent habit and send these patients to a formal consultation.
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References
Nickell D (2010) Screen door medicine: the informal medical consultation. University of Kentucky Doctoral Dissertations. Paper 6. http://uknowledge.uky.edu/gradschool_diss/6. Accessed 2010
Weingarten MA (1985) Off the cuff consultations. Br Med J (Clin Res Ed) 291(6505):1321–1322
Guberman D, Vardy DA, Klaus SN (1994) Corridor dermatology consultation en passant. Arch Dermatol 130(2):233–234
Peleg A, Peleg R, Porath A, Horowitz Y (1999) Hallway medicine: prevalence, characteristics and attitudes of hospital physicians. Israeli Med Assoc J 1(4):241–244
Leavitt FJ, Peleg R, Peleg A (2005) Informal medicine: ethical analysis. J Med Ethics 31(12):689–692
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Kandel, L., Barzilay, Y., Friedman, A. et al. Informal (Hallway) medical consultation in orthopedics—is it as common as it seems?. Arch Orthop Trauma Surg 137, 607–610 (2017). https://doi.org/10.1007/s00402-017-2667-1
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DOI: https://doi.org/10.1007/s00402-017-2667-1