With the new academic year about to start, I thought I'd share some basic 10 tips for successfully making a call to a consultant from the ED for the brand new PGY1s out there.

1. Ask yourself ahead of time why you are admitting the patient. Ask yourself why the patient can't go home. Because rest assured you will be asked this question and you need to have a good answer for it.

2. Get your ducks in a row before calling. Know the patient's name. Have the chart and labs ready. Have an updated set of VSS if you are calling about a critical patient.

3. Call the right person. Many hospitals have complex algorithms for who is admitting for what private doctor. Confirm with the patient who their PCP/specialist consultant is before just firing off the phone call.

4. Do not apologize for calling them or waking them up. This immediately puts you in a defensive position. This is their job, you don't need to apologize. Instead, cordially thank them for taking your call.

5. Lead with the diagnosis and why you are admitting the patient and keep the rest of the presentation short. Especially at night, you will lose most people's attention after the first 30 seconds. If they want more details they will ask. Less is usually more.

6. If you are anticipating a contested admission, think one step ahead in the patient's care. It makes it much easier to get a patient accepted if you can tell the admitting physician what you think the patient needs going forward.

7. Don't ever lie. You will lose all credibility and will ruin your bargaining power for future admissions.

8. Anticipate resistance ahead of time. Learn consultant patterns as to who is always going to resist and be overprepared for those calls. Its ok to compromise sometimes, but also realize some cases are non-negotiable.

9. If a consultant escalates into anger, do not escalate further. Get your attending involved. Ultimately, if a consultant grossly crosses the line, report them for it. Don't let yourself become a punching bag.

10. Don't become the middle man between two dueling consultant services as to who should admit a patient. If the two sides can't agree, put them in touch with each other to fight it out.

Good luck PGY1's!

"The supreme art of war is to subdue the enemy without fighting."
- Sun Tzu