Tuesday, April 24, 2012

Talking to myself in the Emergency Room

Having spent my entire adult working life in medicine I have gotten used to there being quite a few rules.  Some of them are appropriate and improve the care of patients.  Others are silly, and make patient care more cumbersome.  The latter are to be subverted whenever possible.  For the good of the patients you understand, my enjoyment of subversion is simply a happy side effect.

For instance.

One place I work has hospital and clinic physically attached.  I usually work in the ER, but on occasion help out in the clinic.  There is a rule that says the ER doctor can't order outpatient tests.  The rationale being that ER docs are transient, almost fly by nighters who won't be around to inform the patient of results and make appropriate decisions based on said results.  Darn ER doc is probably off lolly gagging.  Sleeping or some such nonsense.

On a lanyard around my neck I have two name tags.  One for ER doctor Me, one for Clinic doctor Me.

So when in my capacity as ER Me I decide a patient needs a follow up outpatient test the conversation is as follows:

"Hi.  This is ER doctor Me.  This patient needs to have this test scheduled tomorrow.  Now, I can't order that so I have spoken with Clinic doctor Me. (randomly flipping my name badges as I speak).  Clinic Me agrees this should be done.  Now, when the test is complete, have the patient go to the waiting area.  Call Clinic Me and he will walk over from this end of the hallway and discuss the results with the patient.  Unless of course Clinic Me happens to be over in the ER.  In that case, call over there and ER Me will temporarily transform to Clinic Me when he comes down that other hallway."

"And of course if there are any problems along the way just have the patient call one or both of us."

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