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> they also should not have stated an opinion without seeing the patient. Doesn't that mean that the doctors choices basically boil down to 1) see every patien

> they also should not have stated an opinion without seeing the patient. Doesn't that mean that the doctors choices basically boil down to 1) see every patient that you get a phone call about or 2) don't take phone calls? Given that I don't think 1 will scale very far it seems like most doctors will have to take option 2, I'm not sure if we're better off in a world where this type of consultation can't happen anymore for fear of liability.

LoSboccacc 7y ago
it's not either or, there's option 3 "I can't form an opinion over the phone, if your medic thinks this can't wait for standard admittance channels I kindly defer you to the emergency services." and likely others.
- smackinglyt 7y ago
  Unfortunately, it's more complex than that. I'm a hospitalist at a pair of community hospitals that don't have some services (cardiology, vascular surgery, neurosurgery, ophtho, etc). I'm used to calling the specialist at our associated academic center when a possible acute problem related to those specialities may be happening. If those specialists now refuse to do "curbside" phone consults because they can't see the patient and now can get sued, these patients are in a bad position. The tertiery hospitals here are constantly full and I can't transfer patients that don't have immediate true emergencies. This opinion is a major loss for patients. And I also used to "decline" direct admissions based on phone consults, telling outpatient AP/NPs what I thought would be a reasonable course of action and follow-up. Will simply say "sorry" on the phone now and tell them to send the patient to the ED, where the costs are very high. This will simply jack up the cost for everyone else. Not saying the MD in the news article had a reasonable opinion. But spend a single day with me in our busy hospital, see just how tricky this profession is, and you might be convinced that I need more legal protection, not less.
  - scott00 7y ago
    In the event a primary care/urgent care doc disagrees with a hospitalist on the need for admission, why is sending them to the ED the right move? I was under the impression the ED is mostly for triage, and it seems like patients in this situation have already been triaged. It also seems like the sort of disagreement about the need for admission between urgent care and hospitalist is also going to happen sometimes between ED docs and hospitalists. How do those disputes get resolved?

LoSboccacc 7y ago

it's not either or, there's option 3 "I can't form an opinion over the phone, if your medic thinks this can't wait for standard admittance channels I kindly defer you to the emergency services." and likely others.

smackinglyt 7y ago
Unfortunately, it's more complex than that. I'm a hospitalist at a pair of community hospitals that don't have some services (cardiology, vascular surgery, neurosurgery, ophtho, etc). I'm used to calling the specialist at our associated academic center when a possible acute problem related to those specialities may be happening. If those specialists now refuse to do "curbside" phone consults because they can't see the patient and now can get sued, these patients are in a bad position. The tertiery hospitals here are constantly full and I can't transfer patients that don't have immediate true emergencies. This opinion is a major loss for patients. And I also used to "decline" direct admissions based on phone consults, telling outpatient AP/NPs what I thought would be a reasonable course of action and follow-up. Will simply say "sorry" on the phone now and tell them to send the patient to the ED, where the costs are very high. This will simply jack up the cost for everyone else. Not saying the MD in the news article had a reasonable opinion. But spend a single day with me in our busy hospital, see just how tricky this profession is, and you might be convinced that I need more legal protection, not less.
- scott00 7y ago
  In the event a primary care/urgent care doc disagrees with a hospitalist on the need for admission, why is sending them to the ED the right move? I was under the impression the ED is mostly for triage, and it seems like patients in this situation have already been triaged. It also seems like the sort of disagreement about the need for admission between urgent care and hospitalist is also going to happen sometimes between ED docs and hospitalists. How do those disputes get resolved?