Dr. Steven Novella

But when we do a consult, like we're at the receiving end of a consult, we're supposed to be educating the person who referred the patient to it.

We explain...

That's fading, though.

Well, I spent my career in an academic institution, and that absolutely colors my perspective.

Certainly within the academic institution where I work, that was the standard.

And that's what I was taught.

That's what I taught other people.

That's what we did.

You don't just say, I'm doing X, Y, Z. You say, this is why I'm doing that.

Right.

And this is what I'm not doing and why I'm not doing that, which is a critical thing that most people do forget to do.

Because they're going to ask you that, why didn't you do this?

So you might as well get ahead of the curve and say, the endoscopy was not indicated for this reason, whatever, prior to doing whatever.

You just give the reason, give the references.

The good thing about EMRs now, electronic medical record, is you could have macros where you just say, you don't have to reinvent the wheel every time.

You just say,

All right, I got a standard migraine referral.

Boom, here is the standard thing that I want general practitioners to know so that they don't send us people who just need to stop drinking caffeine, right?

Because otherwise you get these references, referrals that really should have been dealt with at an earlier stage.

And we see teaching the community as part of our mandate.