Comments on: Consultaholic

By: L&D

L&D — Mon, 29 Dec 2008 21:46:20 +0000

This almost makes as much sense as the OB who needed a hospitalist consult on his gestational diabetic because she was insulin dependent…Said hospitalist was really not happy when he was asked to see the patient in the OR during her c-section! He said no and walked away…

By: Dr. Alice

Dr. Alice — Sun, 30 Nov 2008 01:10:55 +0000

Do the surgery attendings support that kind of behavior? Biliary colic I might put up a discussion about; but acute cholecystitis is one of the most straightforward surgical admits I know. Like Erik says, it wastes time for both sides to make needless consults whose recommendations you don’t particularly need.

By: buckeye surgeon

buckeye surgeon — Fri, 28 Nov 2008 23:19:29 +0000

That story makes me sick. Surgical patients belong on my service.

By: Erik

Erik — Wed, 26 Nov 2008 06:45:47 +0000

From the guy who does the consult:

Do you have any idea how annoying it is to be consulted for something and then:
* see the patient,
* explain the problem to the pt and the family
* write and dictate the note
* write orders

and then have the surgeon who consulted me:

*send the pt home on post-op day #1 with none of my plan followed? OR
* change all my orders without asking me and then call me at 2 AM to tell me the pt is crashing OR
*cancel all my orders but then ask for 2 more “medical management consults”

Would you like it if I sent the pt home after you had planned a surgery, pulled out a drain, or changed your orders for dressing?

Work with me here, docs – or don’t ask me to see your pts.

OK – to be honest, there are lots of great surgeons (at least in my hospital) that a great to work with and really help us act like a team – but they are boring to gossip about.

By: Erik

Erik — Wed, 26 Nov 2008 06:39:53 +0000

ER docs also try to dump their entire service before their shift ends. Medicine docs like me try to stall near the end of shift. It’s human nature.

What exactly is the medicine doc supposed to do with pus in the gall bladder? If you had a surgical emergency, would you want an internist and no surgeon taking care of you?

By: Nurse K

Nurse K — Tue, 25 Nov 2008 08:30:21 +0000

You’ll have to admit her to General Medicine for pre-op clearance and then consult us.

Sorry, medicine didn’t clear her based on her chronic arthritis. Sheesh, looks like we’re going to have to let her die of a ruptured gallbladder and sepsis unless ortho comes down here and does an emergency bilateral knee replacement or cortisone injections. Darn.

By: Jill

Jill — Tue, 25 Nov 2008 04:17:28 +0000

I like your phone defense!!

By: trifling jester

trifling jester — Tue, 25 Nov 2008 02:44:49 +0000

I would have refused that admit if I was the IM on call. Happy to consult on the HTN though lol.

By: Happy Hospitalist

Happy Hospitalist — Tue, 25 Nov 2008 02:28:09 +0000

that reminds me of the notify hospitalist to follow post op for medical management…

on a patient whose only problem is hypercholesterol…

on a patient whose only problem is stable depression…

Dear doctor, if you want someone to take all your annoying pages, hire a full time 24 hour a day P.A. My job is not to make your job easier. It’s to take care of patients with medical problems. When I sign off the case, please don’t get mad at me. You have doctor abilities in there somewhere. It’s time to put them to use.

By: Robin

Robin — Mon, 24 Nov 2008 18:39:38 +0000

These are the kinds of assholes who I play pager games with. They get paged to Wal-Mart, Pizza Hut, the impotency clinic, anYoud about 15 other places. If I have to jump through hoops, I make sure they do, too.

You just don’t want to piss off your nurses. They can be a nasty lot…..