Inpatient Consultative Services
The division maintains two distinct consultative services, one at the Louisville VAMC and one in the downtown Louisville Academic Medical Center (LAMC).
The latter is a large nexus of institutions covering 3 square miles in the geographic center of the two state catchment area of 1.4 million people in southern Indiana and Kentucky.
The medical housestaff at ULH operate at a high level and independently (USMLE scores averaging over 240 this year), producing relatively refined consult requests for a group of complex patients. More routine problems are almost always seen in one of the four clinic settings.
Aggregated data from the two consult services shows that slightly more that one quarter of the consults are for lupus and vasculitis and an equal number are related to complications of rheumatoid arthritis and its treatment, predominantly infection, while 15% are for diseases with monoarticular presentations including crystal diseases and reactive arthritis.
The remaining 1/3 represent unusual rheumatic or immunologic diseases, e.g. macrophage activation syndrome (HLH) and Guillane Barre syndrome.