There are many good doctors out there, and some who perhaps were taken out of the oven a little early. On the phone, it can be difficult to tell the difference. Im here to help. There are a few ways to tell that you may be dealing with a non competitive colleague: They tell you the patient has a GCS of 1 or 2 (you get three for being born) When you ask if the patient is intubated and on a vent, they partially cover the phone, lean away and yell to someone (who I assume is named Bobby) Hey, Bobby! Bobby! That sick un. She gotta tube or no? You are informed that things have been going right bad for the patient. Hey, this is Dr Doctor out at (insert random county name here) Memorial. I got a really interesting case... (pneumonia can be interesting...but generally notsomuch) A great story for septic shock is given to you. The referring provider agrees this is likely septic shock. They digressed the patient because of pulmonary edema. Two days ago. The azithromycin doesnt seem to be helping that much for the line from the nursing home that has all the pus. Things are strangely not going well. Like I said, Dr Norton. This guy is a really interesting case. Marginal oxygen saturation on 100% non rebreather. You suggest intubation before transport. The referring provider feels pretty comfortable that the patient does not need that prior to the hour long ride in rush hour traffic. The resident calls you. He does not know his attendings name. They have not met formally in the three weeks they have been on service together. BUN and glucose are the same number. Potassium and bicarbonate are the same number. We dont have the capability in out ICU like the big city ICUs (generally referring to antibiotics) You are talking to a doctor who is heavily invested I his extremely ill patients care on the phone. In the background, you can hear the waiter ask if he and his wife are ready to order, or you can hear his kids soccer game in the background. Most calls I get are from great doctors who are transferring because a family asked for it or they are in a resource limited environment. But there are a few out there. And yes, I am on call today. And cranky.
Posted on: Sat, 02 Aug 2014 10:55:35 +0000
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