ED Physicians with overkill

Specialties Emergency

Published

Okay....this is the first time I have been in an ED that I have seen this. We have an ED physician that orders EVERYTHING on EVERYONE. For example every abdominal pain gets every lab, every xray and ALWAYS ends up in a CT scan no matter the age. Had a 5 year old that the plan film showed him so full of poop that he could have been renamed "turd", and they STILL did a CT that read "Constipation".

It is very frustrating because every patient is in the ED for 3 to 4 hours unless they are cut and dry....lac, ear ache, sore throat. Fever, Abd pain, Chest pain (no matter the age) all get the big workup. Even if the labs are normal, they end up in CT one way or another... Chest pain...normal labs...Chest CT.... Abd pain....normal labs..... Abd CT..... Fever.....normal labs......They find a reason for a CT.

They do not understand that they are busy all night long because the ED is full and I have no place to put new patients..."bring them back so I can see them".... My question is WHERE do you want me to put them. It is not fair to the nurses nor the patients.

Just curious if anyone else has a physician that is like this....

Thanks for letting me vent.

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Specializes in Emergency Room.

A few weeks ago, I put a patient in fast track with obvious Bell's Palsey. In and out, right? Nope. Head ct.

aaagh.

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Specializes in ICU, ER.

We have one who CTs everything. He has been sued 4 times - won all 4 cases, but it did bad things to his mind. Can't say that I blame him.

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Specializes in ICU;CCU;Telemetry;L&D;Hospice;ER/Trauma;.

yup....

we have one of those....except he's Internal Med....(infernal med)

He's soooo bizaare...

He will order consults up the ying yang...

A patient will come in with exacerbation of COPD....minor ABG changes...like pH=7.2 p02=80 pC02=35.....and he will send them to ICU....demand that the pulmonologist intubate! The patient will be sitting up talking....making sense...on 2L02....resps. 28 min....and just needs a few hits of Duoneb and some RT along with a r/o pnuemonia....and this idiot will put on GI consult...Cardiology consult.....he will have every system covered by a specialist....God forbid the patient should have an ingrown toenail...because then he will call Podiatry!

Then he just walks away....leaves the patient with all these other docs who don't know the patient, and have really no idea why they are being consulted...its such a waste of resources, time, and medicare dollars...

The patient is completely stable....and despite our protests, the patient ends up taking up our last ICU bed....when there's a code or a trauma....we have no bed to put them in....all because of this idiot...

Once, he wrote in the progress notes..."to be or not to be" next to his orders....no kidding....he was spacing out....and they let him retain privileges...

He's delusional....

Somewhere there's a village missing and idiot.

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Yeah, we have one like that as well. He scans something on everybody.

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Specializes in floor to ICU.

one of our ED docs had been sued in the past- he's the one who does big work-ups and admits on everyone

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They do not understand that they are busy all night long because the ED is full and I have no place to put new patients..."bring them back so I can see them".... My question is WHERE do you want me to put them. It is not fair to the nurses nor the patients.quote]

We have one who'll start actually calling pt's back himself! Ooooh! THen the pt's confused, we have to explain what's going on, and the guy just keeps taking pt's and then wonders why in the world everything takes so long!!!:angryfire

He will order consults up the ying yang...

A patient will come in with exacerbation of COPD....minor ABG changes...like pH=7.2 p02=80 pC02=35.....and he will send them to ICU....demand that the pulmonologist intubate! The patient will be sitting up talking....making sense...on 2L02....resps. 28 min....and just needs a few hits of Duoneb and some RT along with a r/o pnuemonia....and this idiot will put on GI consult...Cardiology consult.....he will have every system covered by a specialist....God forbid the patient should have an ingrown toenail...because then he will call Podiatry!

Then he just walks away....leaves the patient with all these other docs who don't know the patient, and have really no idea why they are being consulted...its such a waste of resources, time, and medicare dollars...

Isn't this horrible?? There've been soooo many times I've wasted time trying to help the specialist "understand" why they're there! It's so frustrating! With this guy, he's never been sued, he's just so danged insecure that he'll miss something that "we want to be 100% positive that that's all that's going on and nothing else...":trout:

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I have one doctor who not only works everyone up inappropriately-but even when all is done and normal will admit them anyway. It is basically because he does not want to make a decision by himself. So rather than say "you are okay go home-despite their normal lab work he will admit.

One time the patient was not off the stretcher from EMS yet when he got the pt's name and their doctor. While we were getting the patient on the stretcher he called their doctor and yelled out "Admitting orders for Mr. XXXX" I got on the phone with their doctor who asked what this patient's labs were. I told him we did not even have the patient's blood pressure yet. So-this patient who has known heart disease-who had a little chest pain and did not take his Nitro but instead called 911-ended up being a hold in the ER because this ER doctor did not want to evaluate-treat and release to home.

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Specializes in ER, telemetry.

We have an MD like this. Rumor has it, he has had a pt die d/t missed diagnosis in the past. He orders EVERYTHING. We hate seeing that he has signed up to see our pts. And heaven forbid he see 2 or more of your pts at once!!!

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Specializes in Emergency.

It's a liability issue. Remember clinical judgement?

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Specializes in ER/PDN.

we have a couple of doctors like this. When I work with one of these doctors, I just put an 18 guage in the right AC of everybody because most of them get CTA Chest-he also CTs everybody. I understand-I have also read studies where a CTA is equal to 400 chest x rays!

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Specializes in CT ,ICU,CCU,Tele,ED,Hospice.

yeah we have both extremes in my er .we have one dr that does every test and then despite all normal will still admit pt .then at other end we have one dr that wants barely anything and will d/c orders we start and gets upset if we order a complete metabolic panel instead of a basic met panel .the only time he agrees to a cmp is in a abd pt .errbut i understand its their right as an md and as the one doing the dispo.we all have licenses to protect.

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