I agree it can be confusing but I agree with Laura. If the Doc A knows what is wrong and it is beyond his expertise then to me that is a transfer of care, but lets look at a couple of things,
-- Dr. A knows his pt has rectal bleeding and requests a colonoscopy for his further evaluation. I say no consult he is requesting another physician perform a specific procedure.
-- Dr. A knows his pt has rectal bleeding and requests a specialist evaluate the patient and suggest a colonoscopy as all other diagnostics have turned up negative. I call this a consult, it really is up to the specialist to determine the appropriate test and he is being asked for an opinion.
-- Dr. A knows his patient has say rectal cancer, he requests an oncologist to see the patient and take care of this issue. No consult, clearly a transfer of care.
-- Dr. A knows his patient has rectal cancer and request an evaluation by an oncologist for information on the appropriate type of antineoplastic treatment. I say consult, the specialist's opinion is being requested as to what type of treatment.
This is the way I look at the different scenarios, I hope this is of some benefit.
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