He’s pissed that the attendings are forcing him to repeatedly call specialists in:
Here, all of the attendings keep saying that patients will sue if they don’t like the job we do, so since we’re at a university hospital we call the specialist. That’s Bull****. I went into emergency medicine because I like to do these things….not stay on the phone and watch someone else do my procedure.
Related posts:
- Cover your ass, defensive medicine
- Patient perceptions and defensive medicine
- Some lawyers say defensive medicine isn’t real, but this doctor shows us otherwise
- Defensive medicine becoming standard of care?
- My take: Paying for call, Muslims in medicine
- Defensive medicine op-ed reaction
- On call
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{ 4 comments }
Kevin, while it’s clear you have only a single horse to beat, you do realize that nothing in that thread even remotely addresses defensive medicine, right?
I mean, unless you’ve made a post there in the last few seconds.
I know that it must be frustrating for the resident who wants to do much, but his/her attendings may be teaching an important lesson. The ER docs are often the target of lawsuits in which the first thing the attorney will state is why didn’t you call a specialist. In one case, a facial laceration was repaired in the ER. The patient then sued claiming he had permanent nerve damage and pain as a result of the repair. The inusrance carrier payed a settlement out of court. (The nerve injury was from the fact that the infraorbital nerve was severed in the original injury). Would the patient still have sued if a specialist was called? Most likely, although it would have been the specialist that was sued.
Chris
Must also consider simple economics.
My hospital’s ER does not bill professional services of the docs; they take a salary from the hospital and the hospital pays out of its general funds. This model allows ER staffing not to accomodate at all times medical direction rules (otherwise enforced by the payor, medicare) and shed the cost of collection (from a population that is 50% non-collectable anyway).
Referral to the specialists is the means by which revenues are generated for other departments of the academic physician group and creates billable procedures (MRI, CT, echo etc.) for the hospital.
Referrals are the lifeblood of the economics of my ER. Too bad if the ER residents are merely gatekeepers, but the economic plan rules.
Defensive medicine is a huge issue! Here’s a great resource on it:
Resident Economics
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