Co-management
Formal Definition
A care model in which two distinct physician services share ongoing clinical responsibility for a patient — typically a surgical or procedural primary team co-managing a patient with a medicine or specialty team for complex medical issues.
How It's Used on the Ward
"Medicine is co-managing" or "co-manage the medical issues" — common when a surgical patient has complex cardiac, renal, or endocrine problems exceeding the primary team's scope.
Example
""Vascular surgery post-op day 1: patient with decompensated CHF and AKI — hospitalist co-management requested. Surgical team handles the wound and vascular issues; medicine manages the fluid balance and cardiac medications.""
Clinical Context
Co-management differs from a standard consult: consultants advise, co-managers actively write orders and follow daily. Clear role delineation prevents gaps — who manages anticoagulation? Who adjusts the diuretics? Document explicitly in the co-management agreement note. When in doubt about who is responsible for what, ask directly.
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