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unicorn

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unicorn last won the day on March 31

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  1. The only time I send someone to the ER is when they need something done there that I can't do myself (such as immediate labs, Chest X-ray, etc.). When patients go to the ER themselves, they almost always seem to end up with a CT scan and get sent home on a Z-pak. Documented are crazy exams which they never actually do (i.e. a person comes in complaining of ear pain, and an abdominal and neurological exam are documented, but not an ear exam), and differentials written by computers which are both ridiculous and never really explored (like, no, elephantiasis is not in the differential of that 80 year-old who came in with swollen feet, and if you really considered a DVT or PE, why didn't you even order a D-dimer??). When I ask patients "Did he actually check your reflexes when you came in for an earache?", they usually say no even when the exam is documented. And why order a strep test in the dude with a sore throat and a cough who clearly has a simple cold, if you're going to ignore the negative strep test and send the patient home with a Z-pack anyway?
  2. There are three hospitals within easy driving distance from my office. Some are better than others, but I often roll my eyes regardless of which ER it is. Similarly in other places I've worked with other hospitals. Skilled ER doctors are few and far between. ER medicine attracts physicians who lack commitment. That's the nature of the specialty. FWIW, most of my colleagues are of the same opinion. We talk about this often. Emergency medicine is a specialty in which nothing is really done other than passing the problem to someone else--for the most part.
  3. Is an assisted living facility an option for you?
  4. There is far too little information in your posting to be able to advise you regarding home health. ER physicians are usually the bottom of the barrel within the physician community (for the most part), and I take little stock in what they say. Their job is mainly just figuring out which doctor can actually take care of the patient's problem (and they don't always even get that right). Your primary care physician is in the best position to determine whether you'll benefit from home health care. If you can't make it to your physician's office, then a home visiting RN would probably be appropriate.
  5. Did it reveal that RH has a good 6th sense?
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