When emergency physician Harvey Castro asked a nurse to start a dopamine
dose for a hypotensive patient one day, he watched the nurse leave the
room, find the book that could guide her to the titratable dose, look in
the index and then flip through until she found what she needed. Castro
wondered, Isn’t there a more efficient way?
In 2009, Emergency Physicians Monthly polled 5,000 readers online to
determine if and when EPs altered the tests they ordered out of fear of
litigation. The poll, which garnered 385 responses, may not have been
scientifically valid, but it confirmed what most of us know intuitively –
that there is a significant cost to defensive medicine. Now, the
Pennsylvania College of Orthopedic Surgeons has added fuel to the fire,
publishing a study that confirms the very same thing.
One night on a lonely stretch of Mexican highway, Dr. Haywood Hall
stumbled on a car accident and a man who was unconscious. For 30 minutes
Hall, a vacationing emergency physician, waited for the ambulance to
arrive. When it did come, it was with shoddy equipment, expired Valium
and an undertrained staff. Although Dr. Hall didn’t have a license to
practice medicine in Mexico, he got police permission to help.
Daryl Wilson was a medical student on rotation in the emergency
department when a man with severe chest pain was rushed in along with
his family. Wilson was briefing them on the father’s condition when the
teenage son suddenly stopped him short: “You’re Daryl. You’re the
singer for the BollWeevils!”