Consultative Medicine & Being The “Quarterback” of Clinical Care

Preoperative Evaluations

Internists are often asked to provide an independent evaluation of a patient in several different contexts – perhaps the most common ones being prior to surgery.  An internist may be seeing the patient at the request of the surgeon, or may be the primary care clinician assessing the patient prior to a surgical procedure. At Santa Monica Primary Care, we only perform preoperative assessments among our enrolled patients who we also follow in primary care. This process gives us the experience of knowing a patient prior to surgery, but also the opportunity to follow the patient’s progress post-operatively.

The goals of this evaluation are to determine the risk to the patient of the proposed procedure and to minimize known risks. It also provides an independent assessment of whether or not the patient is an appropriate candidate for the procedure itself. These goals are achieved by the following:

  • Identifying unrecognized risk factors for medical complications of surgery
  • Optimizing any preoperative medical condition(s)
  • Recognizing and treating potential complications.
  • Working together as a member of the preoperative team 

I am never been a fan of the implied diminished “second place” value of a second opinion so refer to it as an “additional opinion.”  These efforts fall under the general term of consultative 

Second (or additional) Opinions

I have never been a fan of the implied diminished “second place” value of a second opinion so refer to it as an “additional opinion.”  These efforts fall under the general term of consultative medicine.

Most commonly, internists are often asked to evaluate a patient prior to surgery. The medical 

Most commonly, internists are often asked to evaluate a patient prior to surgery. The medical, when dealing with a complex medical condition, the diagnosis, treatment and management can be complicated, and making decisions about your health care is important. Getting a second opinion can help you feel more confident about your diagnosis and treatment plan.

There are many reasons why you want to seek another opinion during the course of your care. Maybe you don’t feel confident in your doctor’s ability to treat your condition, or you have a rare or unusual condition. Or your condition isn’t responding to the current treatment.

According to Mayo Clinic patient educators, taking the time to learn about your condition, and getting a second or third opinion is a reasonable approach. Proactive decision-making will give you a greater degree of control over your treatment. Make decisions regarding your health after you have been thoroughly informed about your diagnosis, prognosis and available treatment options.