Friday, August 10, 2012
Our New Reality
Dr Thomas: Hi Dr. Grumet. I was calling in regards to Mr. Chest Pain on 2N.
Me: Oh...hey are you the new guy with Cardiology Physicians, welcome!
Dr Thomas: No. I work with a company called EMR Consultants. We were hired by your hospital to review inpatient hospital stays.
Dr. Thomas: Getting back to Mr. Chest Pain, I see that you deemed his symptoms to be non cardiac.
Me: Correct. He has muscle wall pain from coughing.
Dr. Thomas: So you will be discharging him today?
Me: Well, his cat scan showed bronchiectasis and bronchitis, and his lungs are very tight. I thought he would benefit from steroids and antibiotics. He is ninety years old after all!
Dr. Thomas: Well you put him on oral antibiotics and oral steroids. Could he not get these at home?
Me: Let me ask you this Dr. Thomas. What did you think of Mr. Chest Pain's lung exam this morning?
Dr. Thomas: Of course, I did not examine him. We do chart review only.
Me: Well did it say in his chart that he has to be able to negotiate two flights of stairs to get into his walk up apartment. Or did it mention his wife Rosa?
Dr. Thomas: Well...um...
Me: Probably not since Rosa died six months ago. Dr. Thomas, would it be too presumptuous to ask what kind of doctor you are you anyway?
Dr. Thomas: The last time I practiced, I was a pediatrician.
Me: When was that?
Dr. Thomas: Residency...but your missing the point. You and I are the same. I have flow charts, and algorithms, and guidelines that direct appropriate care. Just like you.
Me: Sorry. We're not the same. I spend my days trying to master the science and art of expert patient care.
You, you make phone calls.
Posted by Jordan Grumet at 5:58 AM