Curbside Consult (James 4:1-3)

A curbside consult is a common occurrence in medicine with colleagues informally seeking advice from each other about their patients. The physician seeking advice will sometimes apologetically begin with a phrase like, “Sorry to do this, but may I curbside you about a case?” In this spirit of collegiality, it is a privilege that physicians should not abuse or take advantage.


In my specialty of dermatopathology, consultations take place with a review of shared microscope slides. A variant of this common practice is to perform retrospective reviews on microscope slides as part of a laboratory’s quality assurance program. Required by both federal and state law, there is no absolute number of cases that need to be reviewed, but most dermatologists who have their own laboratories limit it to five to ten cases per year. One dermatologist with whom I had been working with for several years, would routinely send me about ten cases per year, similar to other clients. However, over time, the curbside consultations increased in frequency and quantity. Under the banner of the quality assurance program, he would send as many as thirty cases per month. These were informal curbside consultations but I later learned that he was incorporating my diagnosis within his formal reports, without my consent nor was I being reimbursed.


It was illegal and definitely unscrupulous. It was obviously taking advantage of an accepted informal privilege for selfish benefits. I discussed his actions with some of my colleagues, who all agreed that it was detestable. I wrote a letter informing this colleague that I would no longer provide these curbside consults. I was incensed but as I reflected upon these unscrupulous interactions, I wondered if I abused my relationship with my heavenly Father?


What causes quarrels and what causes fights among you? Is it not this, that your passions are at war within you? You desire and do not have, so you murder. You covet and cannot obtain, so you fight and quarrel. You do not have, because you do not ask. You ask and do not receive, because you ask wrongly, to spend it on your passions.

James 4:1-3 (ESV)


How often have I taken advantage of the blessings that God has showered upon my life? Instead of praying to Him, expressing my gratitude and sharing my requests, I demand that He listens to me, assuming that I know my needs better than He does. Instead of honoring Him as the omnipotent and omnipresent Creator of the Universe, I have diminished Him to the role of a cosmic bellhop.


This sounds familiar.


I need to look in the mirror to see what is a true definition of unscrupulous.


Love and trust the Lord; seek His will in your life.



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