By HANS DUVEFELT
In some practices, sufferers with seemingly easy issues are scheduled to be seen by a nurse or medical assistant. Generally they will even simply drop off a urine pattern in case of a suspected urinary tract an infection.
It is a harmful entice. 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 positioned; what if they’ve decrease belly ache from an ovarian cyst or an ectopic being pregnant?
One other harmful sort of “nurse go to” is when sufferers give attention to one symptom or parameter, pondering for instance that so long as their blood stress is okay, their obscure 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 an entire totally different factor when it’s the affected person’s thought, assumption or self analysis.
In lots of circumstances, a phone name with the supplier or a triage nurse could be safer and extra diagnostic than beginning with a nurse go to. As a result of the symptom historical past is often extra necessary when making a analysis. And nurse visits are usually skimpy with regards to the scientific historical past, regardless that the supplier assumes duty for the analysis and remedy of a affected person they didn’t speak to or study.
Seemingly easy issues can generally be disasters ready to occur. Nurse visits should not billable, solely the dipstick urine take a look at is in my first instance. However the malpractice payout may very well be greater than for a missed analysis made by a radical clinician in good religion – if there was little scientific historical past and no bodily examination finished, not even eye contact between affected person and treating doctor.
Think about this analogy: How a lot much less is a meal on the takeout window than contained in the restaurant? The associated fee is often the identical and it definitely isn’t free.
A Blissful Meal is a Blissful Meal, irrespective of the place or the way you obtain it. Analysis and remedy should 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, right here.