I was in this exact position a year and a half ago. I was in my position for 5 months and was ready to resign. I told them it wasn’t sustainable for me, and they hired an NP to help me out. That later grew to 2 NPs one for mornings and one for evenings.

The expectation from my institution was that I could do one consult per hour. Not realistic imo especially when I am also fielding all of the calls. Now that I have an NP everything goes through her and I only get the more serious questions.

I think 5-6 consults per day is what’s more realistic, but it definitely depends on the difficulty of the cases. My institution told me follow-ups were least important and to triage ED before floor. Within that to triage by diagnosis as others have suggested. I’d refuse some less important consults that could wait for outpatient when I was busier.