(Snippets from the frontline)
Case scenario of a friend
67 year old male with no significant past medical history admitted to a well-known nationally ranked hospital with weakness and dizziness, and found to be anemic (low red cells).
No history of abdominal pain, change in bowel movements, dark stools, nor blood noted. Last colonoscopy was 10 years before and told to repeat in 5 years. Never had upper endoscopy (looking into the stomach).
Vital signs were stable with a pulse of 100. Physical exam was normal. Stool study was ordered but he had no bowel movement during his 30-hour stay. Iron levels were low. Imaging not done. He was transfused 1 unit of red cells, then discharged home. A colonoscopy was scheduled for 6 weeks after discharge, but no follow-up outpatient lab tests were ordered.
The practice of medicine has changed over the years. I would have minimally ordered a colonoscopy before discharge. Only 24 hours would have been added to his hospital stay, and maybe made a life changing diagnosis.
Instead, the hospital rolled the dice possibly jeopardizing the patient’s health and well-being.
Going with business odds to save money instead of sound medical judgement is not how a hospital should become nationally ranked.
Gene Uzawa Dorio, M.D.
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