Consultation and Team Care

Chapter 3 Consultation and Team Care




Clinical Case Problem 1 Who Ya Gonna Call


You are a recently graduated family physician new to a community practice made up of two other family physicians, a family nurse practitioner, and a physician assistant. You see a 47-year-old patient for several visits and are concerned about whether he should undergo a cardiac catheterization because of a 2-year history of intermittent but stable chest pain and a strong family history of premature cardiac mortality.



Select the best answer to the following questions




1. Which of the following is (are) among the factors you will consider in choosing the consultant?


a. the skill and reputation of the cardiologist

b. the geographic convenience for the patient

c. the experience of other practitioners in your practice with the subspecialist

d. the skill of the consultant is the only important consideration

e. a, b, and c are correct

f. a and c are correct

2. After choosing the appropriate consultant, you dictate a letter. The content of the letter should include all of the following except:


a. a brief history

b. a brief physical examination

c. a directive that catheterization be done as soon as possible

d. the type of help you are asking for

e. any supporting laboratory data

3. Your communication expectations of the consultant should reasonably include which of the following?


a. clear response regarding the diagnosis and management plan

b. justification for the course of action outlined

c. communication about the patient by telephone or in writing or both

d. a and b

e. a, b, and c

4. Your patient sees the consultant and returns to see you 3 weeks later confused by what was told to him by the consultant. You call the consultant but are told by the receptionist that she is too busy right now to come to the phone. Options at this time include all of the following except:


a. ask to speak to the physician later that day when she is available

b. ask the patient to return to the consultant for another visit to get a clearer understanding of the recommendations and plan

c. not using this consultant again

d. seeking the opinion of another consultant if the communication does not improve

e. asking the receptionist to fax the consultant’s letter of consultation if there is one

5. You later learn from the patient that the consultant had referred the patient to another consultant without your knowledge. Circumstances and reasons why this is a problem for both you and the patient include which of the following?


a. such behavior disrupts continuity of care

b. it may result in unnecessary use of additional resources

c. the problem may have been handled by you

d. it may add unnecessary inconvenience and expense for the patient

e. all of the above


Clinical Case Problem 2 Who’s on First, What’s on Second


You attend your first meeting of the practice clinicians and staff. The practice leader says she wants to improve teamwork in the office. She defines teamwork as people working together cooperatively and effectively. Knowing that you have just graduated from a residency program known for its team-based care, she asks your advice.



6. Factors that improve practice functioning and teamwork include all of the following except:


a. building trusting relationships

b. having a diversity of perspectives

c. using mostly written communication

d. encouraging varied interactions

e. b and d

7. Techniques to build some of these factors include all of the following except:


a. create opportunities for interprofessional education

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Consultation and Team Care

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