BASTARD ER Doctors!!!

[Zachary Smith]

You're not in for any problems as far as growth plates are concerned--so long as your above the age of 20 years old or so. By then all your growth plates are closed anyhow. It's a physical maturation deal and part of becoming an "adult". Looking at how close growth plates are to closing is one way forensics guys can tell from skeletal remains if they're looking at an adolescent or an adult.

Gotcha. I don't think two X-rays of his hand were of much harm. I do appreciate the info

No prob. X-rays and other diagnostic imagings are one of those things people love to get and a lot of doctors love to give--whether they're needed or not. Yet everyone whines about the high cost of health care!

I was interning at the Chiroprctic office of the Free Health Clinic here in town last summer when a woman came in with an injured knee, about a week and a half post-trauma. She reported that it still hurt but had been getting better, described the mechanism of injury etc and stated that she was there that day because that was when the clinic was able to schedual her. The MD looking her over asked the Chiro doc I was interning with to have a look also. She (the MD) suspected a minor tear of the medial meniscus. The Chiro doc did a few orthopedic tests and, yeah, they came up positive for a torn meniscus. Well, the MD got all excited and started talking about sending the patient over to the local charity hospital to get an MRI to "confirm". The Chiro doc asked her if it DID come back positive, how would it change the treatment plan (which was at that point R.I.C.E. (rest, ice, compression, elevation) and orthopedic taping to provide stabilization. Best case scenario for the patient was a sprain/strain but likely it was a MINOR meniscus tear. This was evidenced by the patient's history of improvement since the accident and the fact that the knee joint was only mildly swollen/painful and otherwise stable. If the MRI came back with a demonstration of a minor meniscus tear, the treatment would be RICE with ortho taping for stabilization. So WHY charge the patient (in theory--it was a charity hospital she would have been sent to) for a disgnostic imaging procedure that would NOT alter the care of the patient, whatever it showed? The MD reluctantly agreed that there really probably wasn't a good reason to image the knee when you looked at it like that. I don't know who, but SOMEONE got saved the cost of a diagnostic MRI that day--us the tax-payers, I guess--thanks to a little goood ol' fashion "doctoring" and less of a knee-jerk reliance on technical whiz-bang toys!

 

[T J]

I assumed from the first post that she wasn't actually pregnant in the first place. If she had been i think TJ would have stated that clearly.

Thanks for the kind words everyone, believe it or not it actually helps. No, my wife was not pregnant, which was a huge relief. We want kids and someday I'm sure we will. But damn, what a horrible scare. I live in a small town... the ER was actually slow and they are notorious for not being the best and brightest.

My wife, who also works at the hospital as an insurance guru will be filing a grievance with that doc so we'll see what happens.

The doctor diagnosed a miscarriage in a woman who wasn't pregnant?

Did he at least run a pregnancy test before dropping that bomb? Do an ultrasound, if nothing else than to rule out an ectopic pregnancy, which is a life-threatening medical emergency? Good lord.

I know insane huh? As a matter of fact my wife went to see her doc about something a week before and they preformed a pregnancy test and it was not positive. The er doc did a test as well and it came up negative... that's one of the reasons I was so shocked. Had she been pregnant it could have been for more than a week... He was just a freakin' moron. I made my wife take the rest of the week off to recoup from all this. Hell of a thing for a doctor to do...

More and more I realize doctors (mostly er docs) are not in it to treat sick people, they are to pass the time and collect a huge paycheck.

 

[Miss Chicken]

^^^ I had a pregnancy mid-December 1979 that came back negative, Despite that I gave birth to my second son on 8 August 1980, This means I must have 5 or 6 weeks pregnant when that test was done.

A doctor would not automatically think that a negative test means the woman isn't pregnant as it could mean that she is less than 5 0r 6 weeks pregnant especially if the urine used in the test wasn't passed first thing in the morning

The timing of the test.
The level of detectable HCG hormone in a pregnant woman's urine will depend on how far pregnant she is. In most cases, it is possible for a urine pregnancy test to show 'positive' from around the time that the next period would have been due (but not earlier than this). However, a common problem with urine tests is that in individual women, the HCG levels may not be high enough until a few days (or up to a week or so) after the period was due. This means that you may perform an early urine pregnancy test and get a 'negative' result, even though you are pregnant. If the test is repeated a few days later (when the HCG levels are higher), the test should show 'positive', presuming that the pregnancy is continuing.

The concentration of the urine.
The level of detectable HCG hormone in a pregnant woman's urine will also depend on how concentrated her urine is. If the pregnancy is well advanced (more than 5 to 6 weeks, or 1 to 2 weeks after the missed period) then the sample of urine used can be taken at any time of day and will still show as being 'positive'. However, if the pregnancy test is performed early (around the time the period is due) or even in the few days following, the test may only show 'positive' if a concentrated urine specimen is used. Urine passed first thing in the morning (after waking) is usually more concentrated than urine passed during the rest of the day. By using the first urine sample of the morning, the pregnancy test will tend to be more reliable.

SOURCE

So even with a negative pregnancy test the week before, and a negative test done in the evening by the ER doctor there was still a possiblity of pregnancy. So I don't think the doctor was a moron for considering a miscarriage given the symptoms you wife was displaying.

 

[Bluewhale]

Well, I'm glad to hear there was no miscarriage.

ER doctors are kind of hit or miss. The hospital where I used to work had a fantastic ER. But some areas of the country are so desperate for docs they will take anyone. I knew a couple of residents who flunked out because of drug problems who were able to get positions in underserved areas.

That's exactly right. It's not until overseas doctors do quite some time in "non-preferred" areas that they can get permanency in Australia. They are often sent to the outback until they qualify to remain. They are usually in the company of nurses seeking permanency after being newly qualified. If they are truly lucky they may work with a very experienced nurse as a mentor. They rarely have another doctor to confer with and often have to refer to the Internet. We're talking about doctors who may then move to emergency but may have got there without support.

We are supposed to be moving to very high speed internet so that doctors can see another doctor face-to-face, and the patient can be examined by a specialist online, but the last place to receive this internet will be in isolated areas.

Our Govt, facing election as I type, should pay premium wages to experienced doctors to entice them to live in isolated areas for a year. The Flying Doctor service delivers wonderful help in the outback but are very reliant on donations.

We all make mistakes, and the ER doctor we are discussing may have worked more than 24 hours in a row, only getting a nap between so called busy times. I know this because my sister is a doctor and worked 2 years in emergency, with a very experienced team around her. She says she kept going during double shifts because of the adrenalin rushes when pretty badly injured people arrived with only 4-5 minutes notice to "hope for the best but prepare for the worst", apologies to Reacher for quote.

 

[Bluewhale]

^^^ I had a pregnancy mid-December 1979 that came back negative, Despite that I gave birth to my second son on 8 August 1980, This means I must have 5 or 6 weeks pregnant when that test was done.

A doctor would not automatically think that a negative test means the woman isn't pregnant as it could mean that she is less than 5 0r 6 weeks pregnant especially if the urine used in the test wasn't passed first thing in the morning




SOURCE

So even with a negative pregnancy test the week before, and a negative test done in the evening by the ER doctor there was still a possiblity of pregnancy. So I don't think the doctor was a moron for considering a miscarriage given the symptoms you wife was displaying.

 

[tharpdevenport]

Wow, who'd thought we still have threads from 2008.

 

[Bluewhale]

Well written Miss Chicken. You can't tell a woman is definitely pregnant at 6 weeks until a physical exam confirms it. There have been many false results, particularly if we consider you were talking about 1979 when you, Miss Chicken, received a false negative. The thing that has changed since then is the dramatic improvement in scans.

However, this is a sad story whichever way you look at it. I agree that the doctor being called 'a moron' goes too far. If we make mistakes we rarely have to defend ourselves to a wide audience of back seat criticism that only some professions are subjected to. The problem is that we have humans who are fallible, but doing the job as best they can; but they are not computers and I am pleased that they aren't.

 

[Bluewhale]

Wow, who'd thought we still have threads from 2008.

I guess that's why it's good to have new members. I have gone through most of miscellaneous comments and haven't noticed they were really old threads. It appears some people are still interested.

 

[Tora Ziyal]

...It appears some people are still interested.

Um, no. Nobody other than you had commented since 2008, except tharpdevenport and now me, and both of us are just commenting on the peculiar sight of an eight-year-old thread coming back to life.

 

[Mr. Laser Beam]

Fear the Walking Thread?

 

[the 4th hanson bro]

It appears the patient, in spite of efforts to the contrary, didn't survive.