Just babbling

It’s 9:30pm and I’m waiting for my transcription to get done. What is so hard about inpatient services being just remotely organized and calling their consults before the middle of the afternoon? Why do inpatient teams insist on getting outpatient work-ups on inpatients (sorry but restless leg syndrome does not warrant an acute inpatient eval). I saw 3 consults after 4pm today. One was on a patient who had gotten a nerve block in the extremity they insisted I see her for today. Kind of hard to do a neuro exam when the patient can’t feel or move the limb!!


Sorry, just rambling. Way exhausted :slight_smile:

Make you long for the former days of strep throat cultures and UTI?

I like neuro, just wish I could tell people what is appropriate for inpatient work-up and what isn’t. Also, “we just want neuro on board” is not a legitimate consult. We’re not the neuro exam service-- I don’t page cards every time I need a cardiac exam.


I haven’t decided if doctors are lazy or have absolved themselves of any responsibility for their patient.

  • tec Said:
I haven't decided if doctors are lazy or have absolved themselves of any responsibility for their patient.



Yes. I feel your pain.

Mary
  • tec Said:
I like neuro, just wish I could tell people what is appropriate for inpatient work-up and what isn't.



Why can't you? I say blast them all with it! But seriously, hopefully you're getting the opportunity to, at the very least, impart this wisdom onto the medical students--I know we'd appreciate hearing that. It's one of the things we discuss that we'd most like to hear from specialists. As you described, often we're not getting that info from the staff or residents on the services.

Unfortunately it’s usually staff that insist that the residents call the consults. Iowa is much different than Maryland in that at Maryland, calling a consult was sign of weakness as a friend of mine put it. Actually, you had to have done your work-up then you had to know you patient when you called. If you called after 12pm, there was no guarantee your consult would be seen that day, forcing you to be organized. The consult service had the right to refuse consults. At Iowa, if you ask questions of the primary team, the give you crap about why you’re asking so many questions. I was called with a non-urgent consult at 4:30pm today and it was seen today. Would have never happened at Maryland. A completely different culture out here.


I tried the “teaching” approach when I was an PGY-2. The ER and medicine teams weren’t interested.

I feel your pain