title: Hospitalist Versus Subspecialist Perspectives on Reasons, Timing, and Impact of Consultation.
abstract: Hospitalists frequently consult medical subspecialists in the management of inpatients. Given the potential impact on health resource utilization, it is important to understand the working relationship between these groups.
  
  
  
  A cross-sectional survey of hospitalists, n = 655, and subspecialists across Ohio (nephrologists and endocrinologists), n = 293, was conducted to investigate perceptions and communication about reasons, timing, and impact of hospital consultations.
  
  
  
  Survey response rate was 13.3%. Hospitalists were more likely to report subspecialty request to serve as admitting physician with subsequent consultation 63.2% versus 26.7%, p < .001. Hospitalists with a daily workload ≥15 patients per day were more likely to report that this impeded their ability to manage details of patient care versus hospitalists with <15 patients per day, 53.2% versus 24.1%, p = .02, and resulted in subspecialty consultation for problems manageable by the hospitalist, 38.3% versus 6.9%, p = .003. Hospitalists were less likely than subspecialists to report major impact from consultation 50.0% versus 81.0%, p = .001 and they were more likely to report direct communication for urgent consults 97.3% versus 48.8%, p < .001.
  
  
  
  Future work should be aimed at addressing hospitalist workload, improving communication, and ensuring appropriate need and timing of consultation.
authors.forename: Kelly
authors.initials: K
authors.lastname: Pacitti
authors.forename: Anne
authors.initials: A
authors.lastname: Mathew
authors.forename: Amanda
authors.initials: A
authors.lastname: Royse
authors.forename: John O
authors.initials: JO
authors.lastname: Elliott
authors.forename: Kim
authors.initials: K
authors.lastname: Jordan
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D000072097:Endocrinologists / Q000523:psychology*; D005260:Female; D020445:Hospitalists / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072104:Nephrologists / Q000523:psychology*; D009820:Ohio; D012017:Referral and Consultation / Q000592:standards*; D011795:Surveys and Questionnaires; D013997:Time Factors