Even if they came with foot pain.

Um – you have such bad abdominal pain that you came to the emergency room? A CAT scan should be expected in this day and age.

OK – I am internist. My tools are careful, extremely detailed histories, exquisite physical exams, and carefully chosen lab tests. These tools allow me (and my itnernist collegues) to figure out exactly what disease someone has and how to treat it.

ERs are not designed for long, detailed histories or palpating the organ of Zuckerwindal. They are supposed to figure out if the patient has problem that if life threatening or not. Most of them (and most of my ER collegures) do a really good job of this.

You want less CT scans – then stop claiming you have an emergency.

If I go to the shoe store, I should expect to buy shoes, not food. It’s that simple.