By HANS DUVEFELT
In some practices, sufferers with seemingly easy issues are scheduled to be seen by a nurse or medical assistant. Typically they will even simply drop off a urine pattern in case of a suspected urinary tract an infection.
This can be a harmful lure. What if the affected person hardly ever will get urinary infections, has again ache and assumes it’s a UTI as an alternative of a kidney stone or shingles on their again simply the place one kidney is situated; what if they’ve decrease stomach ache from an ovarian cyst or an ectopic being pregnant?
One other harmful kind of “nurse go to” is when sufferers concentrate on one symptom or parameter, considering for instance that so long as their blood stress is okay, their imprecise chest stress with sweating and shortness of breath isn’t something critical. It’s one factor if I would like a few blood stress checks by my nurse, however a complete completely different factor when it’s the affected person’s thought, assumption or self analysis.
In lots of instances, a phone name with the supplier or a triage nurse will be safer and extra diagnostic than beginning with a nurse go to. As a result of the symptom historical past is normally extra essential when making a analysis. And nurse visits are typically skimpy in relation to the scientific historical past, though the supplier assumes accountability for the analysis and remedy of a affected person they didn’t speak to or look at.
Seemingly easy issues can typically be disasters ready to occur. Nurse visits are usually not billable, solely the dipstick urine take a look at is in my first instance. However the malpractice payout could possibly be larger than for a missed analysis made by an intensive clinician in good religion – if there was little scientific historical past and no bodily examination achieved, not even eye contact between affected person and treating doctor.
Take into account this analogy: How a lot much less is a meal on the takeout window than contained in the restaurant? The associated fee is normally the identical and it actually isn’t free.
A Completely satisfied Meal is a Completely satisfied Meal, regardless of the place or the way you obtain it. Prognosis and remedy are usually not outlined by their setting or go to cost.
Hans Duvefelt is a Swedish-born rural Household Doctor in Maine. This publish initially appeared on his weblog, A Nation Physician Writes, here.
