Head & Neck consultations - U pitt? others?

[SLUsagar]

I was interesting in the opinions of folks practicing or upper levels in training on experiences in sending head & neck consult cases to the east coast, U Pitt in particular, as I've become a big fan of Drs. Barnes and Seethala...anyone with experiences in turn-around time, quality of consult, actually answering my question??? [instead of rambling on and on about the extent of nuclear pleomorphism and verbally masterbating about how "variably prominent" nucleoli are...thanks, i looked at the slide too... See how i typically work is i look through the 2 peepholes jutting out of the scope, think, and then make a dx...]

I've got an oddball H&N lesion which I'm pretty certain my diagnosis is correct, but I know my clinicians might balk a bit when I they see my report...so i'm prophylactically gonna send it out. other places folks recommend for H&N? Seems like a lot of the big boys are out east: Mills, Barnes, Wenig...

thanks

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[levels x3]

I recently got a pretty good turnaround time and result from the AFIP on a pediatric head and neck case. The only problem is that they think that they own your block if you send it to them. Make sure you request it back, and make some recuts before you send it just in case.

 

[ImmaculateTurd]

You could try Ben Pilch at MGH.
Bruce Wenig is also a great authority too.

I was interesting in the opinions of folks practicing or upper levels in training on experiences in sending head & neck consult cases to the east coast, U Pitt in particular, as I've become a big fan of Drs. Barnes and Seethala...anyone with experiences in turn-around time, quality of consult, actually answering my question??? [instead of rambling on and on about the extent of nuclear pleomorphism and verbally masterbating about how "variably prominent" nucleoli are...thanks, i looked at the slide too... See how i typically work is i look through the 2 peepholes jutting out of the scope, think, and then make a dx...]

I've got an oddball H&N lesion which I'm pretty certain my diagnosis is correct, but I know my clinicians might balk a bit when I they see my report...so i'm prophylactically gonna send it out. other places folks recommend for H&N? Seems like a lot of the big boys are out east: Mills, Barnes, Wenig...

thanks

 

[2121115]

In terms of turn around time and professionalism with consults, Mayo clinic generally does it better than anyone. However, I'm not sure who the HN path folks are there.

 

[Aubrey]

Mills ftw! Of course, I'm slightly biased.

 

[SLUsagar]

anyone have experiences to comment on with the head&neck folks at U Pitt?? (Seethala, Barnes)

 

[DrBloodmoney]

You could send it to Hefner at the AFIP.

 

[LADoc00]

LOL...is the crew at Stanford stumped or what?

There was a some guy at MSKCC/Cornell I remember everyone used to send ENT path to, forgot the name tho.

 

[SLUsagar]

LOL...is the crew at Stanford stumped or what?

There was a some guy at MSKCC/Cornell I remember everyone used to send ENT path to, forgot the name tho.

i've completed my training and am working currently in prv practice. no i was thinking to send to Barnes and boys after hearing several talks from them and was very impressed. U pitt is uber specialized (jesus checkout their website!!!) great for consultations (for folks in prv practice) dunno how good it'd be for a gen residency.
actually sent the case off already. we'll see how it goes. i have my dx in mind, just need a formal blessing i suppose (i'm noticing that this is often a common theme for some consults)

 

[baoflex]

Westra at JHH has a pretty active head and neck consult service

 

[Absidia]

I am biased too, but Westra is great. He has a very active consult service and does it all (including oral/dental and endocrine).

 

[SLUsagar]

I am biased too, but Westra is great. He has a very active consult service and does it all (including oral/dental and endocrine).

when i was on the consult service last year, i once had a community pathologist call (asking about a challenging dental case) to ask me if I knew anyone in the dept that was good at oral...
(i kid you not)
i bit my lip, held in my bursting laughter, and said i'd have to check and get back to him...

 

[LADoc00]

i've completed my training and am working currently in prv practice.

Jesus, What?! Have I been really reading this forum for so long all the med students are now matched, through training and already have jobs?

OMFG, I need a life. This is sad. I thought you matched at Stanford like last year...

 

[SLUsagar]

I know that Jennifer Hunt has left Clev Clinic and is now at MGH. Does anyone know if MGH has a formal ENT consultation service and if you can request a person to review a case? I thought they all did subspeciality signout, so I assume they have subspecialty consults. But their website isn't very helpful.

 

[green mantis]

There's always that guy Lester Thompson at one of the Kaisers in the LA area.


----- Antony

PS: I just noticed your PMs. I'll respond tomorrow because I should have some downtime.

 

[sohsie]

There's always that guy Lester Thompson at one of the Kaisers in the LA area.


----- Antony

PS: I just noticed your PMs. I'll respond tomorrow because I should have some downtime.

I second sending H&N/endocrine cases to Lester Thompson. He is super quick and will call you personally to discuss the results the next day.

 

[SLUsagar]

too late, i sent it already to Hunt. her talks are meetings are really great. i like her straightforward way of going about thyroid lesions.
i had to call her personally to get the address and confirm she sees consults, the mgh website totally blows, not even a "consult" like or anything. (VERY unlike UPitt's website, if you've seen it).

 

[caffeinegirl]

I'm sorry the MGH consult system isn't clear cut...
Usually for "anybody can read this consult" cases, they get sent directly to Warren 216 (main pathology dept desk) and then get funneled to each subspecialty service (which is great as a resident, since you see cases from the outside from your first year).
For personal consults, the system is less clear cut. Some cases come to the main desk with "attention Dr. X" on them, and then get sent on to that specific attending. However, most attendings get cases sent directly to them (all the attendings info is on www2.massgeneral.org/pathology), which then get logged in by their admin's. As a trainee, you don't get to see them unless you seek the experience...