• Traci N Adams, Joanna Bonsall, Daniel Hunt, Alberto Puig, Jeremy B Richards, Liyang Yu, Jakob I McSparron, Nainesh Shah, Jonathan Weissler, and Eli M Miloslavsky.
• Division of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA. tnfadams@gmail.com.
• J Hosp Med. 2018 May 1; 13 (5): 318-323.

BackgroundMedicine subspecialty consultation is becoming increasingly important in inpatient medicine.ObjectiveWe conducted a survey study in which we examined hospitalist practices and attitudes regarding medicine subspecialty consultation.Design And SettingThe survey instrument was developed by the authors based on prior literature and administered online anonymously to hospitalists at 4 academic medical centers in the United States.MeasurementsThe survey evaluated 4 domains: (1) current consultation practices, (2) preferences regarding consultation, (3) barriers to and facilitating factors of effective consultation, and (4) a comparison between hospitalist-fellow and hospitalist-subspecialty attending interactions.ResultsOne hundred twenty-two of 261 hospitalists (46.7%) responded. The majority of hospitalists interacted with fellows during consultation. Of those, 90.9% reported that in-person communication occurred during less than half of consultations, and 64.4% perceived pushback at least "sometimes " in their consult interactions. Participants viewed consultation as an important learning experience, preferred direct communication with the consulting service, and were interested in more teaching during consultation. The survey identified a number of barriers to and facilitating factors of an effective hospitalist-consultant interaction, which impacted both hospitalist learning and patient care. Hospitalists reported more positive experiences when interacting with subspecialty attendings compared to fellows with regard to multiple aspects of the consultation.ConclusionThe hospitalist-consultant interaction is viewed as important for both hospitalist learning and patient care. Multiple barriers and facilitating factors impact the interaction, many of which are amenable to intervention.

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