(J. Emerg. Med. 2011 May 26 [doi:10.1016/j.jemermed.2011.01.025]). We found that effective organizational skills, interpersonal and communication skills, and medical knowledge were the three most common themes mentioned by respondents.

A novel way of looking at the consultation process is through the 5 Cs model. Adapted from the business literature, this model focuses on five main points: Contact, Communication, Core question, Collaboration, and Closing the loop. If consultations are focused around these five points, I believe we can really improve patient care through improved communication.

This quarterly “Consultation Nightmares” column is aimed at starting, and continuing, the conversation around improving consultations in the ED and across the board in medicine. As we share our stories about and experiences with consultations, we can explore better methods of communication in various situations and discuss the ways to improve day-to-day patient care. I invite you to share your consultation horror stories, submit questions, and make comments. Consider this to be your “Dear Consultant” column!

Dr. Kessler is the Section Chief of Emergency Medicine at Jesse Brown VA Hospital, Chicago, and Clinical Associate Professor in the departments of Emergency Medicine, Medical Education, and Internal Medicine at the University of Illinois–Chicago, where he is also Associate Program Director of the Combined IM/EM Residency. Please send any consultant challenges, questions, or comments to acepnews@acep.org.