In Reply to Hale et al.

We want to thank the authors for their comments on our study and appreciate their work proposing a consultation classification system. As we stated, part of producing an optimal consult is creating a shared mental model between consultant and consultee, which Hale and colleagues’ classification system may optimize. However, we disagree that some consultations may not require a clear consult question. Although patients may be complicated and fall under the “S.O.S consult,” we recommend there still be an associated question to help guide the consultant, as was highlighted by the participants in our study. These S.O.S questions may be more broad or vague, but they can still be clearly stated. These 2 models—the “S.O.S label” and “clear but broad consult question”—can work synergistically to optimize the consult and prevent interteam friction. In addition to enhancing patient care, the generation of a clear question enhances the learning and teaching process which occurs during consultations. Furthermore, we propose in our article that although having an upfront consult question is important, all essential elements must be included to optimize not only the current consult interaction but also subsequent interactions. By classifying consultations into the S.O.S group, the consultees still must include the additional elements to provide a full patient care perspective. Only then can consultants have the information needed to refine or expand the consultees’ original questions. Moreover, it is imperative for trainees to feel comfortable discussing the content of consult questions with their senior team members when it is unclear, which can help refine the question and aid in asking the “right” questions.