tag:blogger.com,1999:blog-1408616337296439010.post914085995617708965..comments2024-01-24T21:28:29.675-08:00Comments on TALES FROM THE SERENITY NOW HOSPITAL: Healthcare Dollars: Part 1 of 2SerenityNowhttp://www.blogger.com/profile/11692300152273949586noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-1408616337296439010.post-48327536071102706572010-07-12T19:06:36.511-07:002010-07-12T19:06:36.511-07:00Yes please cut back on ordering needless UA's....Yes please cut back on ordering needless UA's. I don't know how many absolutely normal urines I have to look at in a night because patients want to feel like their doc is physically doing something about their problem.<br /><br />-crazy medtechlittlewings11https://www.blogger.com/profile/10583495583784969755noreply@blogger.comtag:blogger.com,1999:blog-1408616337296439010.post-69235376803697669242010-07-09T23:47:50.815-07:002010-07-09T23:47:50.815-07:00I have thought that myself for ages. We need to c...I have thought that myself for ages. We need to change the culture of medicine in our country - not just the MD's but the public! People need to learn to NOT expect everything and anything. They need to realise there is not a pill or a test for every complaint. They need to realise that many conditions are self limited! They need to realise we can't figure out every diagnosis! Ah, how I yearn sometimes to be practising in the late 1800's....ERPhttps://www.blogger.com/profile/15973334581468131595noreply@blogger.comtag:blogger.com,1999:blog-1408616337296439010.post-18000676299049559782010-07-08T08:58:44.149-07:002010-07-08T08:58:44.149-07:00Anon,
You are right about the CXRs. In a normal a...Anon,<br /><br />You are right about the CXRs. In a normal asthma exacerbation that is improving with treatments, there is no need for a CXR or antibiotics for that matter. Sometimes these unfortunately get ordered in triage. Others just routinely get it like they get UAs for everything. Personally, I don't order CXRs for standard asthma exacerbations in healthy individuals. Next time, feel free to refuse the XR or discuss holding off on it with your ER doc<br /><br />-ER DocSerenityNowhttps://www.blogger.com/profile/11692300152273949586noreply@blogger.comtag:blogger.com,1999:blog-1408616337296439010.post-89899466396314353822010-07-08T00:27:07.369-07:002010-07-08T00:27:07.369-07:00Ok, same anonymous as above, but with my lawyer ha...Ok, same anonymous as above, but with my lawyer hat on. Two comments:<br /><br />One, there are already rules against frivolous law suits. The issue is finding good ways to deem as frivolous a suit that involves complex information. The other issue is enforcing rules against and sanctions for filing frivolous suits. <br /><br />Two, it's a matter of time. In my state, tort reform is in place and suits are still filed, but the number of law students planning to practice med-mal here can probably be counted on the fingers of one foot. Tort profs actively dissuade students from seeking careers in med-mal. It may well be a dying field. As the costs of the litigation rise and the award caps drop, the possibility of making a living at med-mal keeps shrinking. Give it time. Tort reform will likely change legal culture, but like any culture change, it's going to take time.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1408616337296439010.post-73899931235023406262010-07-08T00:20:01.138-07:002010-07-08T00:20:01.138-07:00But seriously, can I please have an acute asthma e...But seriously, can I please have an acute asthma exacerbation without getting a chest x-ray? Why, dear lord, why? Asthma attacks are not fun. Coughing uncontrollably in between not breathing adequately is not fun. Attempting to stamp completely still while holding one's breathe, very shortly after things have started improving, is sheer torture. Ok, so it's not THAT bad. But it ain't fun, and it's completely pointless. It's a freaking asthma attack. <br /><br />Last time I didn't even go for the asthma attack, I went in twelve hours later for concerns about medication side effects. Didn't escape the chest z-ray. When I was there for potential electrolyte imbalance following the asthma attack. Wth?<br /><br />I once had four chest x-rays in one month, with zero abnormalities. Two ER, one pulmonologist, one GP. <br /><br />Doesn't the fact that I had a severe asthma attack last week and was exposed today to a major asthma trigger and am now having every symptom of an asthma attack which resolve fairly quickly following steroids and bronchodilators possibly strongly suggest that I'm having perhaps an asthma attack?Anonymousnoreply@blogger.com