What is a Consult?

I think one of the more valuable general things I've learned on this rotation is the nature of consult services. It's useful to know when to get a consult and what a consultant does. At least for psychiatry, we get consulted when patients on the general medical wards have mental status changes, suicidal or homicidal ideation, behavior issues, pre-existing psychiatric conditions, legal status problems (such as a psychiatric hold), or questions of informed consent. Consult services expect the consultee to ask a specific question. Sometimes this is general, frustrating, or inappropriate ("she has interesting behavior, go check it out for us"), but usually it gives us a place to start. We then see the patient and assess general psychiatric issues, focusing particularly on the consult question. This allows us to make a recommendation on what to do with the patient; the primary team can choose to accept or reject those recommendations.