Abstract
Objectives
To clarify the value and process of the curbside consultation and identify ways to
optimize this activity.
Participants and Methods
We conducted 13 focus groups at an academic medical center and outlying community
sites (September 2011 to January 2013), involving a purposive sample of 54 primary
care and subspecialist internal medicine and family medicine physicians. Focus group
discussions were transcribed and then analyzed using a constant comparative approach
to identify benefits, liabilities, mechanisms, and potential improvements related
to curbside consultations.
Results
We developed a model describing the role and process of the curbside consultation.
Focus group participants perceived that curbside consultations add particular value
in offering immediate, individualized answers with bidirectional information exchange,
and this in turn expedites patient care and elevates patient confidence. Despite the
uncompensated interruption and potential risks, experts provide curbside consultations
because they appreciate the honor of being asked and the opportunity to help colleagues,
expedite patient care, and teach. Key decisions for the initiator (each reflecting
a potential barrier) include whom to contact, how to contact that expert, and how
to determine availability. Experts decide to accept a request on the basis of personal
expertise, physical location, and capacity to commit time and attention. Participants
suggested systems-level improvements to facilitate expert selection, clarify expert
availability, enhance access to clinical information, and acknowledge the expert’s
effort.
Conclusions
Curbside consultations play an important role in enhancing communication and care
coordination in clinical medicine, but the process can be further improved. Information
technology solutions may play a key role.
Abbreviations and Acronyms:
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Article Info
Footnotes
Grant Support: This work was supported by internal funding through the Knowledge Delivery Center, Mayo Clinic .
Identification
Copyright
© 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- Curbside Consultations: A Call for More Investigation Into a Common PracticeMayo Clinic ProceedingsVol. 89Issue 11
- PreviewIn their grounded theory study published in the May 2014 issue of Mayo Clinic Proceedings, Cook et al1 examined the important issue of curbside consultations. They determined via focus groups of selected physicians that curbside consultations are a valuable practice in clinical medicine and suggested that they merit institutional support. A common theme in the focus groups was that curbside consultations foster effective, bidirectional communication that does not occur when using a static resource such as a textbook, Web-based resource, or literature search to answer a clinical question.
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