Internal Medicine Consult Service

Internal Medicine Consult Service resources are available, by referral, to all inpatients and outpatients at the Clinical Center. The consult service group has experience with both simple and complex medical problems, and is familiar with the NIH intramural research program and Clinical Center environment. The overall objective of the service is to help the research teams provide optimum clinical care.

Certain medical problems are unique to clinical research; they may or may not be defined in the protocol but have a potential impact on the research endeavor. Other medical problems are clearly unrelated to the protocol and need to be considered in addition to the primary research objectives.

Medical Problems Unique to Clinical Research

Clinical manifestations may occur in research patients that are possibly related to the study but not defined in the protocol. These problems are often complicated and difficult to interpret; they can present a significant clinical challenge and may have an impact on the study results. Diagnosis and treatment decisions may involve multiple specialty consultations and diagnostic studies.

The Internal Medicine Consult Service provides consultation in these settings, working closely with the research team, in an attempt to understand the significance of the clinical problem in the context of the study protocol. They have extensive experience coordinating care in the Clinical Center for such complex patients.

Additional Medical Problems

The care of research patients often includes recognition of pre-existing or new clinical problems that are clearly unrelated to the disease or treatment being studied. These conditions may or may not be well controlled by the patient's outside physicians.

The Internal Medicine Consult Service may confirm that no additional care is needed or they may offer further evaluation, treatment and follow-up care while the patient is on a protocol. When appropriate, they will follow the patient along with the research team and provide close communication with the patient's outside physician to coordinate care upon discharge.

Examples of Additional Medical Problems

• Hypertension, diabetes and thyroid disease
• Abnormal laboratory, imaging or EKG findings
• Incidental illness noted at routine protocol visits
• Previously undiagnosed conditions found during screening exams and in normal volunteers
• Complex problems requiring multiple consultants and diagnostic tests

Internal Medicine Consult Service Team