Tuesday, May 25, 2010

Dumb Doctor

I get really tired of primary doctors who don't admit patients to the hospital.....but will send their patients in for bogus workups.

In the middle of a busy shift, I had a very nice 49 year old female who was there for an "emergent MRI." She had a history of an aneurysm 5 years ago. 3 WEEKS AGO she had an episode of dizziness. She correctly made an appointment with her primary doctor. This genious thought that with her medical history and dizziness 3 WEEKS AGO, and NO recurrence of any symptoms since then.....that she needed an emergent MRI. So after going to her doctors, then waiting 4 hours to be seen in the ER, she gets discharged with no emergent MRI.

Even she suspected her doctor was dumb. The only thing she wanted before leaving was the name of a new primary care physician. I was happy to provide her with that.

-ER Doc


Anonymous said...

Now I am a primary that actually does admit my own patients to the hospital so I very rarely send someone to the ER:crushing chest pain with cardiac history and EKG changes, acute neurologic change concerning for stroke with onset within 3 hr time frame, ect.

Now it is possible that this doc was dumb. It is also quite possible, and truthfully more likely unless this doctor has a reputation, that what he told the patient and what she heard where completely different things.

For example:Doctor says'Dizziness can be a concerning symptom. If it happens recurrently or you have other symptoms, particularly neurologic symptoms, we might get a MRI'.
What patient hears'You have cancer and are going to die tomorrow if you don't have a MRI'

SerenityNow said...

Re anon;

You make very good points/thoughts.

First of all, I love PCPs like you. We need tons more like you. This is the only way to make medicine work.

I have seen it both ways (1 the patient freaks about what she hears the doc say and come to the er, and 2 its the docs fault). Unfortunately, this one was the docs fault. Through EMR,I was able to view his note. It said exactly what my history was....dizziness 2 weeks ago, no recurrence of any symptoms since, but because of history needs stat MRI. And he does have a reputation.

I had a PCP send a patient in with "needs stat scoliosis xray series" on a prescription pad!! wtf is that?

Yesterday had a guy come in b/c he received a letter from his PCP saying to immediately go to the ER bc of "abnormal lab results." He had the letter and the results with him in hand. What were the abnormal results??? A wbc of 15.0. Give me a break. Hardly emergent, and the blood was drawn during a case of pharyngitis.

kind of shit that will make you pull your hair out.

-ER Doc

ERP said...

That is called lazy and stupid with a little bit of defensive medicine mixed in.

Anonymous said...

Let me get this straight, the patient had aneurysm then five years later the patient felt "dizzy". The patient had no other episodes of feeling dizzy up to the point this blog was written which is three weeks.

Agree with the doctor's assessment and wouldn't have thought it necessary to have done the MRI.
Plus its probably something wrong with your ears, that is where the equilibrium centers are located, and how you get dizzy.