E.D. Overcrowding

[IRISH BULLDOG]

E.D. Overcrowding

 

We can stop baseless malpractice suits before they get started. How? By having a majority of practicing emergency physicians and physician assistant's go on record as to the baseline “standard of care,” beneath which is negligence. An indistinct line in the sand as to what is acceptable and not acceptable creates an atmosphere where we all do tests and procedures that we know intuitively are unnecessary, costly, and sometimes at the detriment of patients just to Cover Our Anatomy. All E.D. providers hesitate to use our common sense for fear of legal exposure. Coming to agreement on the “best practices” in every area of medicine is an impossible task but we can agree on a baseline of acceptable practice, most notably -- we are not ADDICTIONOLOGISTS.

 

This statement is but the first step. And it might not be the first step that you would take. But it is a first step. Please join together by letting Hospital Administrators and our legal system and the public know we provide Emergency Medical Care. And just as our legal colleagues do, we too have specialties ie; you don't go to a Tax attorney for a divorce. So why go to the E.D. for an RX refill? Why not have a (Pod/Unit) PPod (similar to a cardiac observation unit for off loading chest pains in the E.D.). Have a boarded Addiction Medicine Provider available to off load patients who frequent the E.R. for non emergent medications. After triage and exam they would be sent directly for evaluation and offered help with resources for their needs. We could also track their visit frequency to determine over use of E.D. and address the cost to the system. We would improve efficiency in an already taxed E.D., as well as improve care for these patients and decrease disruptions of other critical patients in the department. Frivolous and false accusations, as well as confrontations with litigious posturing addicted patients, would be removed to an area equipped to address them. This would improve services for all, and make the E.D. a safer place. It will limit the unnecessary time and cost of dealing with the wrong Medical Specialty, and allow us to do what we do best -- Emergency Medicine. Let’s improve our own circumstances.

 

Send this to all of your colleagues. It won’t work without broad agreement. We need thousands of signatures.

 

And watch for other standards. If you would like to put forth a standard for consideration by your colleagues, please email. We can do this, one step at a time.

 

Why this will work

Our legal system recognizes that a providers practice will be deemed to be appropriate if his or her treatment is "what the average providers, who are similarly trained, would do in a similar circumstance." But this simple legal axiom is twisted on its head by the legal practice of pitting one highly paid, intelligent "expert" against another in a court of law. Each of them testifies passionately as to what "they" would do. Often it becomes the battle of the best practices, under ideal circumstances. And of course, this is all after the fact, when the outcomes are known, making even subtle signs and symptoms look obvious. But the legal standard of care is what you and I, average emergency providers, would do under similar circumstances, without knowing the outcomes. We can provide this information in some common frequent situations.

What do you all think?

PISH

Disclaimer: I seek neither agreement nor approval for ANY opinion that I post on the internet...

I am not an expert, I just like to apply logic to everyday situations.