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

From an ER physician:  Write your own admitting orders

Edwin Leap, MD
Physician
April 7, 2015
28 Shares
Share
Tweet
Share

While working at small rural hospital I was once again faced with the emergency physician’s dilemma.  Admitting  a patient and being told to write holding orders.  In the midst of a very busy department, I sat with a nurse who guided me through the ridiculously complex and counterintuitive electronic orders system.  All this so that the admitting doctor wouldn’t have to log onto the computer, from home mind you, and trouble himself.  (Much less come in and see the patient old school; that would be sheer madness!)

Now look, I know I’m with the patient.  But that means I’ve already done the majority of the stuff that really matters.  The rest is housekeeping, and the domain of the patient’s personal admitting physician or hospitalist.  I don’t know when you like your repeat labs, how you like your PRN medications, what you want for hypertension or really what antibiotic pathway you want to employ.  I don’t know when you want him up, or whether or not you want her to have a physical therapy consult.  I don’t know.  And ultimately, I don’t care.  In the same way as an orthopedic surgeon doesn’t really care about which oral hypoglycemic you recommend for his patient, or a psychiatrist which gallbladder imaging you prefer.

It is 2015.  We have telemedicine.  Physicians remotely, hundreds of miles away, read our CT scans and others tell us (also from vast distances) to give thrombolytic drugs.  The Internet makes medicine possible from your bed at night — naked if you like.

It makes no sense for me to read x-rays because it’s after 5 p.m. and radiologists get tired.  And it makes even less sense for me to write admitting orders for patients, when 1) I’m not trained to do it; 2) you’ll do it much better than I will; and, 3) you will be the one caring for them, and the one who should care most about what things are ordered.  Convenience and comfort aside.

I’m not longer an intern or resident.  Write your own admitting orders.  I already did the workup.

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test and Life in Emergistan. 

Prev

Solving bullying: We must begin with ourselves

April 7, 2015 Kevin 10
…
Next

Angelina Jolie's story is one of true courage and grit

April 7, 2015 Kevin 2
…

Tagged as: Emergency Medicine

Post navigation

< Previous Post
Solving bullying: We must begin with ourselves
Next Post >
Angelina Jolie's story is one of true courage and grit

More by Edwin Leap, MD

  • Hospitals at a breaking point: Lack of staff and resources leave ERs in chaos

    Edwin Leap, MD
  • Trapped in a cauldron of suffering, medical staff are weary

    Edwin Leap, MD
  • Vaccine hesitancy is complex

    Edwin Leap, MD

More in Physician

  • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

    Harry Severance, MD
  • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

    Howard Smith, MD
  • Why allowing yourself to embrace discomfort is necessary for personal growth

    Jillian Rigert, MD, DMD
  • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

    Kara Wada, MD
  • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

    Zahid Awan, MD
  • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

    Harvey Castro, MD, MBA
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy
    • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

      Harry Severance, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • A pediatrician’s journey into integrative medicine [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 6 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

  • Could Semaglutide Help Curb Addictive Behaviors?
  • 'If the Narcan Isn't Working, Give More' and Other Myths About Naloxone Use
  • CDC: Children's Brain Infections Rose Last Winter, But Remained Rare
  • Inside the Fight Against Burnout Amid the Chaos of War in Ukraine
  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients

Meeting Coverage

  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients
  • De-Escalated Surgery Suffices for Low-Risk Cervical Cancer
  • More Evidence Backs Gout Benefit for Gliflozin Agents
  • Reaction to FDA's Approval of Upadacitinib for Crohn's Disease
  • CDK4/6 Extends Reach Into Early-Stage Breast Cancer
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy
    • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

      Harry Severance, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • A pediatrician’s journey into integrative medicine [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

From an ER physician:  Write your own admitting orders
6 comments

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

Loading Comments...