Table 2.
Types and Examples of Questions Asked by Primary Care Clinicians Via the eConsult Service
| Question Type | Questions, No. (%) | Question Example |
|---|---|---|
| Diagnosis | 182 (63) | |
| Interpretation of clinical findings | 104 (36) | My patient is a 17-year-old girl who has a fine vesicular rash since a week. Please assess this rash. Could this be a viral exanthema or scabies? (Pictures are attached.) |
| Interpretation of prior testing | 70 (24) | This patient has a mildly elevated prolactin level of 37. Macro prolactin testing is pending. If this elevation is not due to macro prolactin, is this level something to worry about? |
| Diagnostic work-up | 8 (3) | This 36-year-old and 24-weeks-pregnant female has a TSH of 3.7 and free T4 of 13. We are planning to order TPO antibodies; is there any other bloodwork you would recommend? |
| Management | 78 (27) | |
| General management | 70 (24) | I’m sending this eConsult regarding a patient with persistent rectal bleeding from internal hemorrhoids. I am wondering if you have suggestions to stop and pre- vent the bleeding. |
| Should I refer? | 8 (3) | I have a healthy 45-year-old male who describes issues with erectile dysfunction for the past 7 years. Because of his young age, I am unsure of the approach to take at this time. Would this be someone who should be seen by urology? |
| Drug treatment | 28 (10) | |
| Drug of choice for particular condition | 15 (5) | What would you recommend for treatment for hair loss related to PCOS? |
| Indications for initiating therapy | 7 (2) | Would this 79-year-old man benefit from anticoagulation with warfarin? |
| Change in dose or stopping drug | 4 (1) | This patient is requesting to come off her lithium, which she has been on for many years. Her mood has been stable for a long time. Can you advise on the best way to decrease and eventually stop the lithium? |
| Adverse effects/interactions | 2 (1) | Is it safe to start Celexa in a pregnant patient with a declining mood and history of depression? |
| Procedure | 3 (1) | This girl has a small mole that has been the same for a long time, but recently bled without any trauma. The lesion is not painful or pruritic. It is a well-demarcated, round, homogenous 2-mm mole on her arm. Given the bleeding, would you recommend a biopsy? |
eConsult = electronic consultation; PCOS = polycystic ovary syndrome; free T4 = free thyroxine; TSH = thyroid stimulating hormone; TPO = thyroid peroxidase.