Appeal to the higher motive. As health care providers, we have an extrinsic responsibility to provide care, as outlined in hospital bylaws and contracts. However, an often more powerful incentive to see a patient is the intrinsic responsibility felt by most physicians to help others. A tactful reminder to the consultant of the goal to care for the patient can be useful. For example, say, “I know it’s late at night, but this patient has a need for your expertise.”

Be mindful of the consultant’s schedule. On-call schedules can be useful in some mindful planning of when to call for consultation. Calling consultants before they leave the hospital or waiting for a short time until consultants are in the hospital (without detriment to the patient) and mentioning this courtesy helps.

If all fails, challenge your consultant. For the most part, successful people respond to competition and will work to surmount a challenge when given. Appealing to one’s intellectual curiosity can be useful. A few examples that appeal to this side of consultants might be, “This is an interesting case that will need a keen doctor to work him up more,” or, “I think there’s something potentially serious going on with this patient, and I just can’t pinpoint what it is.”

Conclusions

Conflict with consultants is inevitable. However, there are factors that we can control to help mitigate or prevent negative interactions. Cognizance of our demeanor and perspective without jumping to hasty conclusions can help begin a cooperative discussion. Fostering relationships with our consultants builds a foundation of trust. Finally, employing specific strategies to deal with difficult consultants may be necessary. However, it is important to remember that we are not motivated by pride to “get what we want” but by the overarching goal of providing the best care for our patients together.

Disclaimer: The views expressed are those of the authors and do not reflect the official policy of the Department of the Army, the Department of Defense or the US Government.

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