Consults

Learn how to leverage consults to improve access and outcomes.

Endocrinology Consult – Diabetes w/Hyperthyroidism

SPECIALTY
Endocrinology 

CHIEF COMPLAINT
Diabetes w/Hyperthyroidism

COMMENTS TO SPECIALIST
This is an endocrinology consult for a 71-year-old male with a history of controlled Atrial Fibrillation (AF). His recent labs were:

  • January 2024
    • Thyroid-Stimulating Hormone (TSH): 6.900
    • Normal Thyroxine (T4): 7.4
  • April 2024
    • TSH: 5.920
    • Normal T4: 6.5

He has had no history of thyroid disorder.

MAIN QUESTION
Could you provide recommendations for the next steps?  How often should TFTs be repeated? Would you categorize this patient as having subclinical hypothyroidism?

For reference only. This eConsult is based on an actual request for specialist consultation. The primary care provider, specialist, and patient are de-identified to protect private health information (PHI).

Support for Comprehensive Care for Rheumatology

Comprehensive Care

With long specialist wait times, providers across the country are turning to eConsults to offer comprehensive rheumatology care. They often help patients manage chronic conditions like rheumatoid arthritis while dealing with the realities of limited access to specialists. Specialist shortages, limited access, and long wait times for specialty care can negatively impact patient outcomes.

Electronic physician-to-specialist consultations, or eConsults, can help mitigate the challenge of specialist shortages and other delays in treatment by offering comprehensive rheumatology care. An eConsult is an asynchronous physician-to-physician communication about a patient, conducted over a secure digital platform, that enables PCPs to leverage the expertise of physician specialists like rheumatologists. eConsults gives patients immediate access to specialists from within a primary care setting.

Below, we use rheumatoid arthritis, which affects about 1.5 million US adults, as an example of how eConsults can help PCPs collaborate with specialty physicians to manage chronic, complex diseases.

How eConsults help with comprehensive rheumatology care

Diseases like RA can be difficult to diagnose since severity and symptoms vary from patient to patient. Rheumatologists use 6 commonly used tests to diagnose RA. Working with a rheumatologist is important for accurate diagnosis and staging. However, timely access to a rheumatologist can be challenging due to a shortage of rheumatologists, high demand, and the resulting long wait times for consults.

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