Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Requiring doctors to give orders on patients they have not seen

Steven Reznick, MD
Physician
January 4, 2012
121 Shares
Share
Tweet
Share

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the patient requires admission. In most cases, the community physicians have no idea the patient is actually at the ER until they receive that call.

It is bad medicine to issue patient orders on a patient you have not seen, taken a history from or performed an examination on. To complicate matters, the hospital does not require physicians to actually come in and see the patient for 12 hours after admission.   Think about it, diagnostic and care orders are being given routinely by doctors who have not examined the patient. The doctors then have the latitude to not show up for half a day to actually do an onsite evaluation.

One of the cardinal rules of medical training is you should do a thorough history and exam before constructing a theory of the causes of an illness and instituting diagnostic and therapeutic measures. The local hospital rule is a direct effort of the hospital to control all aspects of patient care for financial gain. They are buying up practices, revamping medical staff bylaws by manipulating the rules and, filling the decision making committees and legislative physician groups with salaried doctors they control.

Hospitals perceive community based physicians who are advocates for their patients as a threat to their financial planning.  The goal is to drive out the community based physicians because they act as a check and balance to the designs of the hospital system working as advocates of their patients. Do not believe for one moment that the goals and aspirations of patients in a community setting are aligned with the goals and aspirations of hospital administration.

I recommend that citizens look into the politics of their local hospital system.  If you do not, you may find that your doctor can no longer take care of you when you are sickest and in need of those professional services provided by someone who knows you well. You may find that you are transported from the ER to the floor quickly but you may not get to see a doctor for half a day.

How should this policy be altered to make sense?  Staff physicians should have 90 minutes to arrive at the ER and assume the care of their patients. In critical life threatening situations requiring immediate intervention, hospital ER staff should be providing stabilizing care until the patient’s care team arrives.

Requiring doctors to give orders on patients they have not seen is bad medicine. Giving those same doctors 12 hours to show up is irresponsible.

Steven Reznick is an internal medicine physician and can be reached at Boca Raton Concierge Doctor.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

How our emotions can affect our decision making ability

January 4, 2012 Kevin 9
…
Next

The lack of underrepresented minorities in STEM

January 4, 2012 Kevin 4
…

Tagged as: Hospital-Based Medicine

Post navigation

< Previous Post
How our emotions can affect our decision making ability
Next Post >
The lack of underrepresented minorities in STEM

More by Steven Reznick, MD

  • Physicians spending more time with computers than patients

    Steven Reznick, MD
  • Navigating the new norm: a physician’s perspective on caring for sick patients in the age of COVID

    Steven Reznick, MD
  • Some health issues should not be evaluated in the office

    Steven Reznick, MD

More in Physician

  • The essence of health narratives, including poetry

    Arthur Lazarus, MD, MBA
  • Discover the power of patience

    Diane W. Shannon, MD, MPH
  • Doctors rediscover joy in practicing medicine, on their own terms

    Kim Downey, PT
  • Physician return-to-work policies

    Deepak Gupta, MD
  • How my patients’ Zoom backgrounds made me a better doctor

    Joseph Barrera, MD
  • Understanding reproductive rights: complex considerations

    Anonymous
  • Most Popular

  • Past Week

    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
    • Addressing dual diagnosis needs in addiction treatment

      Susan Hertz Berrick, EdD | Conditions
    • The essence of health narratives, including poetry

      Arthur Lazarus, MD, MBA | Physician
    • Discover the power of patience

      Diane W. Shannon, MD, MPH | Physician
    • Doctors rediscover joy in practicing medicine, on their own terms

      Kim Downey, PT | Physician
    • End-of-life ethics and antibiotic use [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 19 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Novavax's Updated COVID Shot Authorized by FDA
  • SBRT Noninferior to Conventional RT for Intermediate-Risk Prostate Cancer
  • Mixed Bag for Early Metformin in Gestational Diabetes
  • FDA Advisors to Consider DFMO Maintenance for High-Risk Neuroblastoma in Kids
  • Adding Tirzepatide to Basal Insulin Cuts HbA1c in Poorly Controlled T2D

Meeting Coverage

  • SBRT Noninferior to Conventional RT for Intermediate-Risk Prostate Cancer
  • Mixed Bag for Early Metformin in Gestational Diabetes
  • Adding Tirzepatide to Basal Insulin Cuts HbA1c in Poorly Controlled T2D
  • Low Relapse Rates With Twice-Yearly Schizophrenia Treatment
  • Menopause Can Negatively Affect Women's Careers
  • Most Popular

  • Past Week

    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Understanding reproductive rights: complex considerations

      Anonymous | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • When physicians are disrespected [PODCAST]

      The Podcast by KevinMD | Podcast
    • Addressing dual diagnosis needs in addiction treatment

      Susan Hertz Berrick, EdD | Conditions
    • The essence of health narratives, including poetry

      Arthur Lazarus, MD, MBA | Physician
    • Discover the power of patience

      Diane W. Shannon, MD, MPH | Physician
    • Doctors rediscover joy in practicing medicine, on their own terms

      Kim Downey, PT | Physician
    • End-of-life ethics and antibiotic use [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Requiring doctors to give orders on patients they have not seen
19 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...