Doctor’s Diary December 5, 2017: Rolling the dice with chest pain

(Snippets from the frontline)

Rolling the dice with chest pain

You are awakened with crushing chest pain and brought to the emergency room.  Initial testing reveals no heart attack, but you are admitted to EDIP (emergency department in-patient) under outpatient Observation Status.

The hospital places you in a statistic category of “low risk”, and typically one undergoes stress test screening for coronary artery disease.  If negative, you go home; if positive, you are admitted.

Makes sense.

But some hospitals minimize care for these patients by rolling the dice that odds don’t favor heart disease.

First, you are kept in EDIP, a section of the emergency room with less oversight.  Believe me, there is a vast difference between care rendered in EDIP than if you are admitted into a hospital bed (especially with pharmacy, respiratory treatment, nursing delegation of care, and various therapies). 

Second, there is strong likelihood stress testing will not be performed by a cardiologist, but instead by a non-physician.

Financially, these odds makes sense for hospitals, but medically it could now place you at higher risk.

Rolling the dice might save hospitals money, but Vegas odds should stay in Vegas.

Gene Uzawa Dorio, M.D.

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