Here is an article (free full text) in Clinical Infectious Diseases on adherence to recommendations of infectious diseases consults.
The authors reviewed 465 consultations at 2 academic institutions. The overall adherence was 80%, with 85% adherence to crucial recommendations. Using multivariate analysis, adherence to ID recommendations was highest for therapeutic recommendations instead of diagnostic recommendations, when they related to a specific clinical question, and when recommendations were deemed crucial by the ID service. Not surprisingly, adherence was greater if the primary service was medicine.
I have always felt that for a consult to be meaningful it must be focused, answer the clinical question(s) in a prioritized fashion, and, be succinct. In a busy hospital, no one has the time or inclination to read an overly verbose consult.
Brevity is key.
