Clinical consultation involves seeking guidance and feedback from other experienced clinicians on challenging cases or ethical dilemmas. It’s often done in small groups with a facilitator and can be done either in-person or virtually.
Practitioners with primary responsibility for patients must be free to consult, even in situations where health care guidelines or managed care protocols mandate referral. Open communication and established professional relationships facilitate effective consultation.
What is a Consultation?
A consultation is a formal discussion with another doctor, nurse or other health care provider about a patient. A consultation may be in person, by telephone or two-way video conference, and will usually focus on the test result that was ordered from MyPrecisionLabs. It is often the case that a consult will lead to a follow up appointment with another specialist.
Consultations are typically sought when practitioners with primary clinical responsibility recognize conditions or situations that extend beyond their level of expertise or available resources. Traditionally, these practitioners acted as independent agents who decided when and what type of consultation was appropriate and were free to choose particular consultants. Today, recognizing the importance of respect for patient autonomy, the referring practitioner must inform patients of the need for and the purpose of consultation and allow the patient to participate in the selection of her consultant (see Box).
To be effective, consultations require efficient and collaborative working relationships. In addition, practitioners with primary clinical responsibility and consultants must agree on the limits of their respective roles in order to provide patients with the best possible care. This can be accomplished by developing a system of communication, for example, by using electronic means of communication such as email. In addition, a protocol should be established regarding the transfer of information from consultations to the medical chart.
Who is a Consultation Patient?
Practitioners with primary clinical responsibility must recognize when a patient’s needs go beyond their education, training and/or experience and seek consultation 2. This is a necessary step in establishing the consultative relationship that ensures that the best interests of the patient are paramount. 2.
Generally, consultations are sought when practitioners with primary clinical responsibility realize that they have limited resources or technical expertise in managing a particular medical case, such as an abnormal labor or an undiagnosed chronic uterine bleeding disorder. In some cases, health care guidelines and protocols dictate that a practitioner must consult with a specialist, such as transfer of a high-risk pregnancy to a perinatal center or referral of a patient with ovarian cancer to a gynecologic oncologist 3.
The consultation process can take many forms, including in-person visits and two-way videoconferencing. Regardless of the format, the consultation should always include the following:
What is a Consultation Group?
A consultation group is a gathering of clinicians that meets on a regular basis to discuss clinical cases and support one another in their work. Typically, groups are led by a senior clinician or other professional that is experienced with group case discussion. Many therapists report that being part of a consultation group is an invaluable way to get support and insight for their work.
In addition to the obvious benefits for patients, there are also many benefits for the therapists themselves. They report that it is energising, supports personal development and helps them get to the bottom of the issue more often in clinic. The ability to share ideas in a safe environment can also be helpful for clinicians who may not feel comfortable discussing issues such as sexuality or gender with their colleagues face to face.
Consultation groups can be found face to face or online and the most important thing is that the group is led by someone who has experience with group case discussions. The best groups are those that value both content and process and encourage therapists to talk openly about their mistakes as well as their successes (Napan, 2021). They also ensure that the group maintains appropriate boundaries and manages conflict effectively. The group should also focus on developing strategies for dealing with difficult situations and addressing ethical concerns.
How to Find a Consultation Group
Clinical consultation is an essential component for many therapists’ professional growth and development. It can help therapists stay fresh and up-to-date with evidence-based practices and address their concerns about casework in a safe, confidential environment. This type of peer group can be found in person or online and is offered by private practice clinicians, mental health organizations, and professional associations.
If you are interested in finding a consultation group, start by asking for referrals from a trusted colleague or by searching online. Alternatively, you can also attend a conference or other therapist networking event where a discussion of these groups may be taking place.
Ultimately, you will want to choose a consultation group that fits your schedule and your desired outcomes. Some groups offer ongoing sessions, while others meet on a “as needed” basis. You will also want to consider how much structure you would like, if any. Some groups may be led by a supervisor or other more experienced therapist and have strict guidelines for member participation, including confidentiality and how to handle conflict.
If you are new to the process of joining an online clinical consultation group, be sure to clearly communicate with the other members about what you hope to get out of the experience. For example, you will want to clarify the level of confidentiality, how the group will handle conflicts, and who will take the lead for how long.