I had the opportunity to shadow an ER physician the other day. Before shadowing him I was always impressed by his ability to quickly identify and prioritize emergencies and care for them appropriately. I even liked him personally. Don't get me wrong I still like and respect him because he is a good person as well as an excellent EM doc. However, I did see something that made me question not only his thought processes but EM in general.
"It's not really my problem, it's not an emergency."
The patient was in his mid-thirties complaining of severe groin pain that hasd smoldered over the past couple of days and peaked earlier today prompting this ED visit. Dr. Cool explained that the emergent condition, the one he could treat, was a testicular torsion, however his gut feeling told him that it was Epididymitis.
In this case, luckily for the patient, it was not a torsion. He would get an antibiotic and be on his way. In and out, that's the goal.
In the mean time Dr. C ordered some blood test and an ultrasound of the guys nuts. We wandered around and seen a couple of other patient's. Finally, after the blood test and the ultra sound returned everything was reviewed and a dx was made. It was in fact epididymitis, the testicle wasn't injured and it also had unimpeded blood flow. However, the patient's creatine was threw the roof. Dr. Cool looked back at the patient's past history and noted that the patient was not having problems urinating and never had.
He then discharged the patient without mentioning the fact that his blood test were not normal.
Is this a big deal?
I personally trust this doctor and believe that he would not do something to harm someone. What bothers me is the fact that we all know that even the best doctors can become indifferent when so much pressure is put on them to move people in and out like cattle.
From someone looking in from the outside it almost felt like Dr. Cool was ignoring something because it may increase his workload just because it may not have been an emergency.
On one hand I completely understand why this happens and the patient's health beyond a life threatening condition is their problem. However, I do think the test results should have been relayed to the patient with hopes that the patient would follow-up with their primary care provider.
"It's not really my problem, it's not an emergency."
The patient was in his mid-thirties complaining of severe groin pain that hasd smoldered over the past couple of days and peaked earlier today prompting this ED visit. Dr. Cool explained that the emergent condition, the one he could treat, was a testicular torsion, however his gut feeling told him that it was Epididymitis.
In this case, luckily for the patient, it was not a torsion. He would get an antibiotic and be on his way. In and out, that's the goal.
In the mean time Dr. C ordered some blood test and an ultrasound of the guys nuts. We wandered around and seen a couple of other patient's. Finally, after the blood test and the ultra sound returned everything was reviewed and a dx was made. It was in fact epididymitis, the testicle wasn't injured and it also had unimpeded blood flow. However, the patient's creatine was threw the roof. Dr. Cool looked back at the patient's past history and noted that the patient was not having problems urinating and never had.
He then discharged the patient without mentioning the fact that his blood test were not normal.
Is this a big deal?
I personally trust this doctor and believe that he would not do something to harm someone. What bothers me is the fact that we all know that even the best doctors can become indifferent when so much pressure is put on them to move people in and out like cattle.
From someone looking in from the outside it almost felt like Dr. Cool was ignoring something because it may increase his workload just because it may not have been an emergency.
On one hand I completely understand why this happens and the patient's health beyond a life threatening condition is their problem. However, I do think the test results should have been relayed to the patient with hopes that the patient would follow-up with their primary care provider.
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