Sunday, June 27, 2004

A little behind the curve here, but I wanted to comment on recent posts from Kevin MD and Medpundit on the use, misuse, and abuse of the emergency room. Reasons such as convenience, avoidance of referrals, multiple opinions, and inability to see one's own physician are given to explain this. While many visit the ER for things that can be evaluated at the office or clinic, acute abdominal pain is not one of them. Almost weekly my office fields a call from a physician's office wanting to send over someone with a "rule out appendicitis" problem. They get all worked-up when we ask they be sent to the emergency room. They complain about the wait, the crowds, ect.. I have to explain that while my office is pleasant and well equipped there are somethings we can't do:
Draw labs
Perform x-rays
Give IV fluids or pain medications
All of which are essential to evaluate a patient with acute abdominal pain. So if I see them in the office it's off to the ER anyway...
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