undefined

undefined

doi:undefined

https://doi.org/10.1007/s43678-025-01025-x

Defining emergency physicians' consultative roles in emergency care: a scoping review.

Nov 3, 2025
CJEM
Joshua Cunningham +4 more

Listen

Abstract

Translate Article

Take Notes

Emergency physicians have a core professional responsibility to provide expert consultative advice regarding emergency medical care, but it is unclear how their consultative role manifests in health systems and whether there is potential to expand those capacities. The purpose of this study is to identify, clarify, and map key concepts related to emergency physicians acting as consultants within health systems. This scoping review searched MEDLINE, Embase, Cochrane, CINAHL, and grey literature. No date restrictions were used and only articles in English were included. Two authors conducted screening of titles and abstracts followed by full texts independently and in duplicate. Data were narratively synthesized. We screened 8744 articles and included 67 articles which included data from 15 countries and were published between 1974 and 2023. Emergency physicians were reported to assume three main consulting roles: (1) real-time support to other clinicians providing emergency care, (2) rapid critical medical response, and (3) response to direct referrals. The most common consultation modes were via telemedicine (56 studies), activation of hospital protocols (6 studies), and referrals to the emergency department (six studies). Few studies contextualized these roles in relation to health systems or access to emergency care. Emergency physicians assume multiple consultative roles within health systems. We define "consultative emergency medicine" as a core competency of emergency physicians focused on the provision of advice to other care providers on individual patient care or health services for conditions that require rapid intervention to avert death or disability, or for which delays of minutes to hours render care less effective (i.e. emergency care). As emergency care develops globally, advancing "consultative emergency medicine" may be a tool to expand emergency care expertise to other providers requesting assistance with emergency care.

Similar Papers

News Article
3
10.1016/j.annemergmed.2006.04.004

Specialty prepares for The Future of Emergency Care in the United States Health System: IOM report release anticipated

Jun 15, 2006
Annals of Emergency Medicine
Eric Berger

Specialty prepares for The Future of Emergency Care in the United States Health System: IOM report release anticipated

Front Matter
15
10.1016/j.annemergmed.2004.11.026

Improving Quality of Asthma Care After Emergency Department Discharge: Evidence Before Action

Jan 19, 2005
Annals of Emergency Medicine
Brian H Rowe + 1 more

Improving Quality of Asthma Care After Emergency Department Discharge: Evidence Before Action

News Article
3
10.1016/j.annemergmed.2013.01.002

NIH Launches Emergency Care Research Office: Coordinating Center Lauded but Challenges Noted

Feb 20, 2013
Annals of Emergency Medicine
Maryn Mckenna

NIH Launches Emergency Care Research Office: Coordinating Center Lauded but Challenges Noted

News Article
2
10.1016/j.annemergmed.2016.02.014

Emergency Physicians Seek Their Place in a Pay-for-Value World

Mar 23, 2016
Annals of Emergency Medicine
Jan Greene

Emergency Physicians Seek Their Place in a Pay-for-Value World

Research Article
10
10.1016/j.annemergmed.2019.03.018

Freestanding Emergency Departments: What Is Their Role in Emergency Care?

Jun 8, 2019
Annals of Emergency Medicine
Alexander J Alexander + 1 more

Freestanding Emergency Departments: What Is Their Role in Emergency Care?

News Article
1
10.1016/j.annemergmed.2013.03.010

Emergency Care Crisis in the United Kingdom and Ireland: Emergency Physician Exodus Looms in Wake of Pay Cuts, Staffing Shortages

Apr 24, 2013
Annals of Emergency Medicine
George Flynn

Emergency Care Crisis in the United Kingdom and Ireland: Emergency Physician Exodus Looms in Wake of Pay Cuts, Staffing Shortages

Research Article
5
10.1111/1742-6723.12181

International emergency medicine: Past and future

Feb 1, 2014
Emergency Medicine Australasia
Peter A Cameron

Much has been written about the development of emergency medicine (EM) and its impact on the medical system as a whole. It is still described as ‘new’ and very much seen as a specialty that is evolving, rather than a static domain of knowledge and skills with rigid boundaries. In reality, the fundamentals of emergency treatment in mitigating the effects of acute illness and injury go back to ancient times. This is evidenced by descriptions of the urgent management of acute pain with analgesics, splinting of injured limbs, and more sophisticated procedures, such as the removal of kidney stones and craniotomies. The treatments at that time were limited, but the application of these skills brought relief to many people (and a little pain). The practitioners were generalists and did not limit themselves to emergency treatment alone. Over the past half-century, there has been an acceleration of development in emergency medical treatments and a massive explosion in emergency medical system enhancement. This has resulted in a unique body of knowledge and skills, with the evolution of a new medical specialty specific to the delivery of emergency medical care. It is worth reflecting on the drivers for EM specialisation, where the specialty has come from, and what we can expect as the complexity of medical care increases with technological innovation and social changes associated with increasing connectivity.