The next chapter in Flea’s saga with the ER. Again, I side with the ER on this. Unless you’re physically at the hospital and assuming liability, there is no place for a PCP to dictate care over the phone to the ER. If you don’t agree with the disposition plan, it’s your responsibility go to the hospital at 3am and do what you want. Until then, let the ER handle it. GruntDoc responds:

Any you wonder why they don’t want to call you.

The ED doc got an interpreter, got a history, evaluated the patient and called you. Your hangup? Not that a patient you’d seen earlier in the day was getting worse, it’s about a change from hours to days in the history, or historical alternans, the rule in medicine, not the exception.

Your “Sure” indicates more about your interaction with the ED docs and opinion of them than the rest of the piece. Certainly it wasn’t a translation error or a misunderstanding, no, it was a Poor History.

I’m not the least bit surprised they called you back to tell you of a change in referral centers; you’ve obviously made quite an issue of being notified, and no ED doc now wants to get the ‘you know, Flea thought you were sending them to X when you sent them to Y’ chat. And that’s on you.

It’s an odd dynamic you’ve chosen to have there. Hope it’s working out like you foresaw.