The trouble with defensive medicine is separating the cost of avoiding lawsuits from the cost of avoiding mistakes.
Example: hen I was an intern a female patient came in acting very oddly. She had a long history of anxiety and depression and I was pretty sure her indifference to her surroundings and refusal to speak (though her eyes were open and she was moving all extremities) was something like a conversion reaction. I called the attending and asked which psychiatrist to call.
Example: hen I was an intern a female patient came in acting very oddly. She had a long history of anxiety and depression and I was pretty sure her indifference to her surroundings and refusal to speak (though her eyes were open and she was moving all extremities) was something like a conversion reaction. I called the attending and asked which psychiatrist to call.
"Start with Jack Alpert," was his response.
"But he's a neurologist!"
"I know and I have no problem calling psych as well. But a neurologist is easier to justify in court."
So I called the neurologist, who said I was probably right...and did a lumbar puncture, which diagnosed the woman's encephalitis.
So my question to you now is when I see a patient who reminds me of this one, is my LP defensive medicine or simply being careful not to miss something?
So my question to you now is when I see a patient who reminds me of this one, is my LP defensive medicine or simply being careful not to miss something?
Posts
