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    Thursday, September 30, 2004

    Where Did All the Doctors Go? ABC notes that emergency room physicians are having problems getting specialists to come in for emergencies, but they blame the shortage on a "relaxation" of federal rules. I suspect there's another reason - malpractice insurance crisis.

    UPDATE: From a doctor in a non-medmal crisis state:

    While the malpractice crisis may be responsible for some specialists not responding to call from the ER, I don't think it explains all. Working here in a tort reform state where there is no malpractice crisis, we have the same problem. It is not limited to specialists coming in for call for patients from the ER, but has spread to specialists and GP's not coming in to to see their own patients. The ER and hospital are covered off hours, holidays, and weekends, by the ER docs, the radiologists, and the hospitalists. I will admit, we do see our surgeons, generally, when needed, since this is a big source of new patients. It has become quite clear that our practicing physicians, however, are not taking their own call and are utilizing the ER docs to screen thier own patients. I have even recommended to our ER staff tht they charge these docs for taking their call and present them with a contract. This is one of the reasons for excessive ER care. Many of the GP's and medical specialists don't even respond to phone calls on call, so all information on these patients is limited to their history, and hospital records, if any. These patients, including oncology patients, often have to be reevaluated from scratch if they come in off hours, because we are all at a loss as to what is going on and have no information. This includes not only, oncology patients, but cardiology patients, rheumatology patients, endocrinology patients and GP's. Most GP offices have off hours messages for their patients, that state the office is closed, and if you have a problem, go to the ER or call 911. There is no service option to talk to the doc covering your physician's practice on call. What are patients to do? And then the worst part for those of us in the hospital on call, is trying to get the responsible private doc on the phone to communicate with them serious information about their private patient who might require some form of urgent intervention, to find out what they want us to do and who they want their patient to see. Many times it takes hours to get a return phone call, and frequently no response at all.
     

    posted by Sydney on 9/30/2004 08:31:00 AM 0 comments

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