I'm currently on the medicine consult service. We manage medical issues in surgical patients, but I've found it to be primarily used by surgeons as a way of getting out of dealing with ANY non-surgical issues.
The frustrating thing is, most of our consults are from Orthopedics and Neurosurgery - these are very competitive fields, so I find it hard to believe people who got 280 on their USMLE Steps1 and 2 all of a sudden are completely clueless when it comes to medicine. Perhaps picking up a bonesaw kills brain cells?
Here are actual consults I've gotten
1) Diabetes management - in a patient that had well-controlled glucose at home. They didn't even consider putting him back on his home dose of insulin
2) Syncope, in a patient that had not, in fact, fainted. Don't know why it didn't occur to them to actually ask the patient this very important question before calling.
3) STD check. At least the neurosurgery resident was apologetic, saying "sorry for the consult but I wasn't sure what to order", but they couldn't be bothered to look it up on uptodate themselves?
We've gotten dozens of consults for simple problems with basic management, where it just seemed they just had no interest in dealing with the problem. If there's one thing I've gotten from this rotation, it's a loss of respect for the surgery profession in general.
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