PROSPECTIVE-STUDY OF 2,092 CURBSIDE QUESTIONS ASKED OF 2 INFECTIOUS-DISEASE CONSULTANTS IN PRIVATE-PRACTICE IN THE MIDWEST

We prospectively studied 2,099 consecutive informal (or ''curbside'') consultations (CCs) posed of two infectious disease OD) consultants in private practice in different cities. The frequency of CCs was simila r for the two physicians: 31 and 30 per month. The majority of CCs (69 %) were initiated by staff physicians, of whom 47% were engaged in pri mary care. The average duration of CCs was 5.1 minutes overall and inc reased significantly from 3 minutes in 1990 to 7 minutes in 1994 for o ne consultant (P < .0001). Overall, 52% of questions asked by staff ph ysicians were considered inappropriate (on the basis of their complexi ty); this rate increased from 40% in 1990 to 53% in 1994 for one physi cian (P = .005). Although a variety of subject matters were represente d, questions concerning treatment of specific infections were the most common. We conclude that the demand for community-based ID physicians ' informal advice remains significant. Any need-assessment for the pra ctice of these specialists in the community should take into account t heir often unrecognized direct and indirect contribution to the care o f many patients they never formally see.