Medicine departments at many academic institutions have created Medicine Consult Services that provide consultative and perioperative care in the hospital. At some institutions consult services are engaged in both pre– and postoperative care, providing continuity for patients. At other institutions, solely preoperative evaluations and recommendations are provided for surgeons to incorporate into their care. In yet another model, consultations are only available postoperatively. Other models have included comanagement agreements for certain situations, commonly with orthopedic or neurosurgical colleagues. This chapter reviews the approach for medicine consultation at the University of Washington Medical Center.
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