Acromion Posted August 28, 2016 Share Posted August 28, 2016 I have been working in EM for 3 years post grad and will be starting a locum job doing IM in a multi specialty clinic in a few months. I am worried that I may be stuck in an acute care mindset. It's dawned on me that I haven't titrated BP meds or insulin since school. I also have no clue on how to manage chronic pain issues, for instance, when to order imaging on a chronic back pain, when to refer a patient to ortho for a knee replacement. It seems to me that the mentality in EM is to over test for everything. Someone who comes in with uncomplicated epigastric pain may get a full suite of belly labs and perhaps even a stat ultrasound to rule out GB pathology, whereas in clinic the appropriate course would be a trial of a PPI and to follow up or go to ER if worse. I was wondering if anyone could recommend some reading material that could help me hit the ground running. Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted August 28, 2016 Share Posted August 28, 2016 CMDT is a good place to start I think. Another good source might be "The Patient History. An Evidence-Based Approach to Differential Diagnosis." covers a lot of when to refer patients. Amazingly I found a copy on pdf at: https://scm2016.files.wordpress.com/2013/08/the-patient-history-2012.pdf You should be able to find a reasonable priced CMDT in ebook form on Amazon. Hope this helps. New grad here so others may have better sources. Link to comment Share on other sites More sharing options...
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