Educational influences on consultation rates of house staff physicians in a primary care clinic

Consultation rates of medical house staff physicians were examined in a primary care setting in order to determine the factors that lead to the use of consultants. The factors that were studied in the regression analysis were clinical experience and teaching in medical school, intensity of use of services, residency year, Alpha Omega Alpha (AOA) membership, and future practice plans. The factors were marginally useful in predicting surgical consultations but were helpful in explaining the use of other consultations. House staff physicians with a pattern of intense ancillary service utilization also requested more consultations. Senior house staff physicians requested fewer consultations than junior house staff members. AOA members and future academic physicians used more consultations than other physicians. Consultation rates were highest for specialties requiring the lowest quantity of education in medical school. Consultation patterns reflect past educational experiences and future practice plans of medical house staff physicians and may be useful in the formulation of the curriculum of medical schools and residencies.