Wednesday, May 6

A Letter in the File of the Attending Physician

A Letter in the file of the Attending Physician at the Riverbend Urgent Care in Springfield, Oregon.

Firegeezer, my first read every morning, brings a tale of a Doctor who sent a man from the clinic in one corner of the hospital to the ER in the same complex. LINK over to Firegeezer for the report and video, then come back.

The gentleman in the story was informed by the clinic staff he should be seen in the ER and when he asked if he should walk or get taken over in a wheelchair the Doctor tells him, "We'll call you an ambulance."

Put yourselves in the shoes of the crew that arrives. If the layout is as described,(remember the video) would you load the man in your rig? Would you wheelchair him to the ER? Would you laugh out loud and tell the Doctor he's part of the problem? Or would the private ambulance crew be reprimanded for not putting the patient in the ambulance to generate a bill for transport?

This Doctor was clearly so afraid of being liable should something happen in the moments between locations, it clouded his judgment as to what was best for the patient.

Best for the patient is a calm transfer from location A to location B.

Time after time our service gets called to the office side of a hospital campus to transfer folks to the ER, often from a 911 activation. When we arrive we find a stable patient who needs "tests and x-rays." Unfortunately this building has no physical attachment to the ER, so away we go. It's so close that I have to give my 1 minute ETA radio call prior to loading the patient. It gets especially awkward when the patient's condition calls for cannulation and I have to delay transport or transfer to do the Doctor's job before I hand the patient off to another Doctor.

This is all hindsight, I understand that, but you can't tell me there was no staff available in the clinic to wheel this particular man to the ER, within the same building complex.

Isn't that what they keep raising our premiums for? For patient care? Or is it for all that advertising at the local baseball park?

Doctor, you screwed up on this one, and every other one you've sent from urgent care to ER by ambulance. You clearly have no understanding of the abilities of the modern ambulance compared to the advancements in wheelchairs.
And another thing, the hospital complex looks fairly new. Perhaps they might have considered putting the urgent care near the emergency care. If I can figure that one out what are all you high paid folks doing all day long?
At my local medical complex the elderly and pediatrics have to walk all the way around the building to get in, but the dental offices are front and center. Way to think that one through giant insurance company.

Doc, I can only hope you're getting a financial kickback from the ambulance company because if this was your idea of a working system, we're in trouble. If it was up to me you'd be assigned to an ambulance for 48 hours to see exactly the impact your little calls are having on your community and just how little the ambulance crew can do in a minute and a half crossing a parking lot.
But you've designed the system in such a way that all I can do is yell at the clouds.

1 comment:

emt.dan said...

You hit this on the head, as usual.
I work for a private ambulance service that has a contract at a large, academic, urban medical center. Unfortunately, this is standard practice, and I do it at least once every 2 weeks. This is so for several reasons, not all of them good.