Comments on: "Demand to see a specialist" http://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: lawyersuxhttp://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html#comment-67267 lawyersux Thu, 21 Sep 2006 18:18:00 +0000 http://clients.emmense.com/kevinmd/2006/09/demand-to-see-a-specialist.html#comment-67267 "It's called a clue. Apparently some ER docs aren't paid enough to buy them."<br/><br/>Glad you've spent so many years of working overnights and showing up to work with a waiting room filled with 50 patients waiting to be seen and you're single coverage. But then again, since you easily disparage ER DOcs, I'll retribute, of course you're too stupid, you're from Bama, probably the product of Consanguinuity. “It’s called a clue. Apparently some ER docs aren’t paid enough to buy them.”

Glad you’ve spent so many years of working overnights and showing up to work with a waiting room filled with 50 patients waiting to be seen and you’re single coverage. But then again, since you easily disparage ER DOcs, I’ll retribute, of course you’re too stupid, you’re from Bama, probably the product of Consanguinuity.

]]> By: SarahWhttp://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html#comment-67260 SarahW Thu, 21 Sep 2006 15:25:00 +0000 http://clients.emmense.com/kevinmd/2006/09/demand-to-see-a-specialist.html#comment-67260 Tick-borne illness in Alabama is not rare. Tularemia is one of those diseases and you can pick it up in Alabama.<br/><br/>Ignoring,or rather, scoffing at a history of tick bite at a patient who presents classically with fever, chills and shaking within 24-48 hours of a tick bite (in this case near woods inhabited with rodent resevoirs like rabbits and mice and voles) is just willful, intransigent stupidity.<br/><br/>Not ordering tests with a shotgun approach is admirable, but that hardly <br/>was the case here.<br/><br/>"Most patients with fever don't have a tick-borne illness" does not tranlate to "most patients who have fever and chills and shaking within 24-48 hours of a woodland tickbite" don't have a tick-borne illness"<br/><br/>It's called a clue. Apparently some ER docs aren't paid enough to buy them.<br/><br/>It would not have been innappropriate to order a panel of tests for tick-borne illness, or to simply refresh ones knowlege database with a quick look-up to see how typical the patients presentation would be for tick-borne illness and what tests, if any would be appropriate. Tick-borne illness in Alabama is not rare. Tularemia is one of those diseases and you can pick it up in Alabama.

Ignoring,or rather, scoffing at a history of tick bite at a patient who presents classically with fever, chills and shaking within 24-48 hours of a tick bite (in this case near woods inhabited with rodent resevoirs like rabbits and mice and voles) is just willful, intransigent stupidity.

Not ordering tests with a shotgun approach is admirable, but that hardly
was the case here.

“Most patients with fever don’t have a tick-borne illness” does not tranlate to “most patients who have fever and chills and shaking within 24-48 hours of a woodland tickbite” don’t have a tick-borne illness”

It’s called a clue. Apparently some ER docs aren’t paid enough to buy them.

It would not have been innappropriate to order a panel of tests for tick-borne illness, or to simply refresh ones knowlege database with a quick look-up to see how typical the patients presentation would be for tick-borne illness and what tests, if any would be appropriate.

]]> By: lawyersuxhttp://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html#comment-67247 lawyersux Wed, 20 Sep 2006 23:48:00 +0000 http://clients.emmense.com/kevinmd/2006/09/demand-to-see-a-specialist.html#comment-67247 I was tested for Q fever once, and hadn't been out of a city for 10 years. Fear of litigation makes MD's order some pretty strange tests. I was tested for Q fever once, and hadn’t been out of a city for 10 years. Fear of litigation makes MD’s order some pretty strange tests.

]]> By: Tdochttp://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html#comment-67244 Tdoc Wed, 20 Sep 2006 21:57:00 +0000 http://clients.emmense.com/kevinmd/2006/09/demand-to-see-a-specialist.html#comment-67244 Tualremia has to be pretty rare in Alabama. RMSF maybe, lyme maybe, but Tularemia. Doesnt that come from infected rabbits rather than ticks? Obviously my ignorance is showing, but I never saw a case in my 5 years there. Tualremia has to be pretty rare in Alabama. RMSF maybe, lyme maybe, but Tularemia. Doesnt that come from infected rabbits rather than ticks? Obviously my ignorance is showing, but I never saw a case in my 5 years there.

]]> By: lawyersuxhttp://www.kevinmd.com/blog/2006/09/demand-to-see-specialist.html#comment-67234 lawyersux Wed, 20 Sep 2006 16:35:00 +0000 http://clients.emmense.com/kevinmd/2006/09/demand-to-see-a-specialist.html#comment-67234 He's right. An infectious disease doc should be stationed in every ER these days. As well as a hand surgeon, Neurologist, Rheumatologist, Dermatologist, podiatrist, Pediatric Cardiologist. "Just in Case" . Then when these uninsured patients who won't even pony up a $10 co-pay coe in, we can order every test "just in case". So they won't sue our Butts. Man, I can't wait till my canadian license comes through. He’s right. An infectious disease doc should be stationed in every ER these days. As well as a hand surgeon, Neurologist, Rheumatologist, Dermatologist, podiatrist, Pediatric Cardiologist. “Just in Case” . Then when these uninsured patients who won’t even pony up a $10 co-pay coe in, we can order every test “just in case”. So they won’t sue our Butts. Man, I can’t wait till my canadian license comes through.

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