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Medical Consultations

Patients with coexistent medical problems should have a presurgical consultation with an appropriate specialist. This has become more complicated with the increase in day and outpatient surgery. It is much easier for a patient to be referred for the surgical correction of a problem without a general medical evaluation. Such patients require the surgeon to exercise special diligence to detect silent medical conditions that may complicate surgery or recovery. These patients should be seen by an appropriate specialty consultant before the surgery. This consultant must write a presurgical note detailing the patient's medical status and any special considerations in the surgical and postsurgical care. The consultant should personally follow the patient's care after surgery or detail the circumstances in which further consultation is necessary. If the patient may require substantial critical care after surgery, either as a usual consequence of the surgery or as a common complication, it is valuable for the critical care medicine service to see the patient before surgery.


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