36 y/o female chief complaint at triage: “I forgot why I came. Gimme a minute and I’ll remember!”
Archive for the ‘Neurology’ Category
Listen, just because you finally managed to drag Gramps in to the ER to see a doctor for the first time in years for an acute but mild problem, doesn’t mean it’s appropriate to ask me to have three specialists see him for a whole boatload of progressive, non-urgent problems.
It’s called make a friggin’ appointment with someone and drag his old bones to their office! Getting ER consults is expensive and when not indicated, are a waste of resources and a strain on our already overused health care system. They tend to order lots of expensive tests and scans, all of which can be more cheaply and appropriately done as an outpatient.
How else can one explain when an 80 year old guy on dialysis becomes 100% completely unresponsive all of a sudden? No response at all to deep painful stimuli. Nada. The episode was witnessed and there was no obvious seizure. Blood sugar normal. BP normal. Vitals other wise normal. Labs unremarkable. CT normal.
And then all of a sudden, he is awake again at his demented baseline about 2 hours later! He has no recollection what happened.
You know what you do? You discharge him. What the Hell else are you going to do? A billion dollar workup? Of course the problem is that there are a lot of doctors (and family members) who would do or want just that. Some things are just not worth investigation. Let them be.