Monday, January 28, 2008

"Go to the ER"

FROM AN EMERGENCY MEDICINE PHYSICIAN...

Here's my biggest peeve. As an Emergency Physician, I actually enjoy helping out my colleagues in other specialties. I love calls from my consultants like the gastroenterologist who says "I've got a guy coming with melena who is on coumadin. I don't want to put him on the floor without knowing how badly he's bleeding, and I'm tied up at the other hospital. Please check him out for me and give me a call. I am truly happy to do this at all hours of the day.

What I hate are the "go to the ER" docs. This phenomenon usually arises about 4pm, is prevalent amongst the PCP's who use hospitalists (that way I either get to be the bad guy or I get to argue with the hospitalist about a bullshit admit), and is a metastatic problem on Fridays.

I used to cover for these guys, but I've stopped. When I hear (as I do every day): "My doctor sent me here for an MRI of my back and admission for pain control"....I just explain to the patient that their doc had the ability to order the test and arrange their admit by making 2 phone calls, but wouldn't. As a result of their doc's laziness and lack of concern, I also advise the patient that they will be getting a bill from the ER and from me which will add over a thousand bucks to their tab.

I then advise them to find a better PCP.

Yeah, patients lie about this, but I hear it all day, every day....so it isn't all patient driven. I know the PCP's are busy, but Christ, I am a lot busier, gimme a break.

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