Tuesday, February 27, 2007

Advice to ER patients: "Say, 'I need to be tested.'"

Liliana Pezzin regarding the CT-angiogram for the evaluation of chest pain. She clearly isn't an advocate of the routine history and physical by asking patients to demand this new, expensive test.

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Comments:
At my school they teach us that the history and physical is the most important part of the exam! That is absurd what that woman is telling patients to do!

theanonymousmedicalstudent.blogspot.com

ps- any chance i could get a link? I've linked you...
# posted by Blogger The Anonymous Medical Student : 1:23 PM
 
Very very irresponsible reporting. The data on this has not defined its utility. This not take into effect the false positive rate (especially when testing a low risk group), or the radiation.
# posted by Anonymous Anonymous : 5:05 PM
 
Unfortunately for you and your patients Anonymous Medical Student, you will find lots of doctors on medblogs who will insist to you that the H & P is an anachronism. Testing is where it's at. It's justified by fears of malpractice, but it's more likely due to poor clinical skills and prolonged deterioration thereof.

Today's examples:
1) 6 y/o child sent in by ER and PCP for followup of Acute Otitis Media. He presented to the ER a week ago because of bloody otorrhea. No history of chronic OM. Getting better on antibiotics. Oh, and he had a CT scan- beats me why. Any particular reason this kid should be seeing a specialist for an ear infection?

2) Adult male comes in with complaint of unilateral hearing loss. He has clear fluid in his right middle ear. Asks me why his PCP didn't see it. Beats me. Maybe he needed a CT scan.

This happens EVERY single day. And you wonder why this journalist is telling readers to
get tested?"
# posted by Anonymous Anonymous : 5:19 PM
 
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