Comparison of emergency and consulting physicians’ perspective on emergency room consultation

Purpose: Effective consultation in the emergency room (ER) improves patient outcomes and reduces the burden on the healthcare system. One of the most serious issues that arises during consultations is the behavior of physicians and their ineffective processes. However, no research has been conducted to compare the perspectives of the physicians as well as the psychological effects during consultation. The primary outcome was the ER consultation process from the perspective of emergency and consulting physicians. The secondary outcomes were inappropriate behavior and its effect on emergency physicians’ (EPs) mental health. Methods: : This study included emergency and consultant physicians from nine departments. Participants (N = 144, 115 consulting physicians and 29 EPs) completed questionnaires that included items about Chad Kessler’s 5-C model (contact, communication, core question, collaboration, and closing the loop) and emergency and consultants’ behavior or problems. Data were collected from February 2022 to June 2022. Results: : Most of the steps in the 5-C model had a mean score higher than 7.0. There were significant differences (p < .05) in all domains of Kessler’s 5-C model when comparing the perspectives on EPs’ behavior between the two groups. Disrespectful behavior was the most common inappropriate behavior among the consulting physicians. The most inappropriate behaviors of EPs were “an EP could not be found bedside” and “consulting about a condition that could be managed as an outpatient.” EPs believed that being “concerned about consulting with the same physician in the future” was the top psychological effect, with a mean (SD) of 4.7 (2.7). Conclusions: : Physicians agreed that Kessler’s 5-C model can lead to effective consultation and conflict reduction. Including this model in residency-training program is recommended. Physicians should improve their communication skills and avoid disrespectful behavior.