Table 2

Types and Examples of Questions Asked by Primary Care Clinicians Via the eConsult Service

Question TypeQuestions, No. (%)Question Example
Diagnosis182 (63)
 Interpretation of clinical findings104 (36)My patient is a 17-year-old girl who has a fine vesicular rash since a week. Please assess this rash. Could this be a viral exanthema or scabies? (Pictures are attached.)
 Interpretation of prior testing70 (24)This patient has a mildly elevated prolactin level of 37. Macro prolactin testing is pending. If this elevation is not due to macro prolactin, is this level something to worry about?
 Diagnostic work-up8 (3)This 36-year-old and 24-weeks-pregnant female has a TSH of 3.7 and free T4 of 13. We are planning to order TPO antibodies; is there any other bloodwork you would recommend?
Management78 (27)
 General management70 (24)I’m sending this eConsult regarding a patient with persistent rectal bleeding from internal hemorrhoids. I am wondering if you have suggestions to stop and pre- vent the bleeding.
 Should I refer?8 (3)I have a healthy 45-year-old male who describes issues with erectile dysfunction for the past 7 years. Because of his young age, I am unsure of the approach to take at this time. Would this be someone who should be seen by urology?
Drug treatment28 (10)
 Drug of choice for particular condition15 (5)What would you recommend for treatment for hair loss related to PCOS?
 Indications for initiating therapy7 (2)Would this 79-year-old man benefit from anticoagulation with warfarin?
 Change in dose or stopping drug4 (1)This patient is requesting to come off her lithium, which she has been on for many years. Her mood has been stable for a long time. Can you advise on the best way to decrease and eventually stop the lithium?
 Adverse effects/interactions2 (1)Is it safe to start Celexa in a pregnant patient with a declining mood and history of depression?
Procedure3 (1)This girl has a small mole that has been the same for a long time, but recently bled without any trauma. The lesion is not painful or pruritic. It is a well-demarcated, round, homogenous 2-mm mole on her arm. Given the bleeding, would you recommend a biopsy?
  • eConsult = electronic consultation; PCOS = polycystic ovary syndrome; free T4 = free thyroxine; TSH = thyroid stimulating hormone; TPO = thyroid peroxidase.