Turfing
Formal Definition
The informal practice of transferring a patient to another service or specialty, often motivated by a desire to reduce workload or avoid managing a complex patient rather than by genuine specialty indication; considered ethically problematic when the transfer is not in the patient's best interest or when the receiving specialty is not the appropriate management team.
How It's Used on the Ward
"Turfing" or "getting turfed" or "this is a turf job" — passing a patient to another service to get them off your list, rather than because they actually need that specialty.
Example
""Orthopedics called about Mr. Jones, admitted for a hip fracture who now has a sodium of 126: 'We are not sodium specialists — please have medicine manage this.' Medicine fellow: 'This is mild dilutional hyponatremia requiring fluid restriction — within orthopedic management. Happy to advise by phone. Not accepting a transfer for this.'""
Clinical Context
Turfing is distinct from appropriate consultation: appropriate consult — specialist expertise genuinely needed, patient benefits; turf — service wants the patient off their list or wants another service to "own" a problem they can manage. Recognizing when you are being turfed: the referring team's question could be answered with a curbside, the clinical issue falls within general medicine, the consult comes with "and can you manage?" rather than "can you advise?". Systemic turfing reflects poor interdepartmental culture and harms patients through delayed care and communication gaps.
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