I found a reference on the subject, and the translation "consulta monografica externa" in English was "specialized [outpatient] unit." I lost the ref; I'll look for it and get back.

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Note added at 14 mins (2008-12-30 22:50:48 GMT)
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Here's the reference:

Palabras clave: EPOC; Consulta monográfica; Minimización de costes; Efectividad; Eficiencia ... ORIGINAL ARTICLESEffectiveness and Efficiency of a Specialized Unit in .... outpatient unit for a consultation with arespiratory specialist, ...
linkinghub.elsevier.com/retrieve/pii/S1579212906601274

We don't "monographic" in medical English the way it's used in Spanish. In Spanish, it means "focused on one subject."

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Note added at 26 mins (2008-12-30 23:03:09 GMT)
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Apparently it is an outpatient unit, specialized in the one area.

If the term "monographic" existed in English, it would have appeared in the English abstract; instead, they translated it as "specialized."

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Note added at 40 mins (2008-12-30 23:17:09 GMT)
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To answer your question, I think it simply means that the consultation is focused on the one subject. The "consulta monografica" is an outpatient clinic that only looks at one problem - as opposed to the "integrated" approach that is now so popular, in which the public health service is becoming "one-stop-shopping."

The idea in general behind the word "monograph" is that it goes deeply into a single subject - and yes, to a very expert level. And yes, more than one expert can contribute to a monograph - but they are focused in that one area.

Merriam Webster defines "monographic" as referring to a written monograph but uses the example: "monographic studies of narrowly specialized topics."

There are no definitions of "monographic" on the Web, and the definitions of "monograph" all refer to a book on a specific subject. The use of "monografico" in Spanish is medical slang that does not have any equivalent in English.
Definitions of "monograph":
* a detailed and documented treatise on a particular subject
wordnet.princeton.edu/perl/webwn

* A monograph is a scholarly book or a treatise on a single subject or a group of related subjects, usually written by one person. It is a one-time publication that is complete in itself. It may refer to a detailed, well-documented work on a limited subject or a person.
en.wikipedia.org/wiki/Monograph

* A separate treatise on a single subject or class of subjects, or on one person, usually detailed in treatment but not extensive in scope and often containing bibliographies.
library.manoa.hawaii.edu/about/collection/glossary.html

* A scholarly book, book-length essay, or pamphlet on a specific subject. ...
library.semo.edu/learn/glossary.shtml

* Offers detailed coverage of a single topic in a narrative sequence and is intended to be complete in itself. ...
library.ups.edu/research/guides/libterms.htm