Consultation between colleagues of different specialties about patients in our hospitals frequently ignores proper ethical principles and may therefore create problems and bad feelings.
1. A junior resident doctor may send a consultation about a patient directly to a consultant in another department sometimes before the patient was seen by the consultant in charge. The proper way is that the consultant in charge of the patient should send the consultation. This ensures that he has seen the patient and that the consultation is needed. Not infrequently, the consultant in charge can solve the problem when he sees the patient or decides that it is not a priority and not needed at that time. It also avoids the possible feeling by the consulted doctor of being treated without due respect because the consultant in charge has not taken the trouble of writing the consultation himself. There may be an excuse for the junior doctor to do so in a case of emergency when time is vital and delay may harm the patient but this is not frequent and should be explained in the consultation letter.
2. A consultant doctor may ask one of his juniors to respond to a consultation directed to him by a consultant colleague. This deprives the patient of receiving the best available opinion and is not good manners as it does not show respect to the doctor who consulted him. The proper way is that the consultant should respond himself if the letter of consultation has been written by a consultant colleague.