I read this article about a young child with heterotaxy syndrome with great interest. Not because I find heterotaxy syndrome something of great fascination, but because of the lack of communication — on both ends of the spectrum:
Even though 5 other Dr. all came in and listened to his lungs and said that he didn’t sound like he was wheezing and that his lungs sounded really good. But because this hospital is overly political, process driven, bureaucratic, and in a constant state of litigious fear they are unable to make any conclusions based on actual medicine and patient care. Common sense is blown out the window when you have a system were a hospitalist one year out of medical school has an opinion that is as valuable as a cardiologist with 25+ years experience.
But in fairness, they all had to “really consider her opinion.”
So they went and got a pulmonologist to evaluate him, which Scott and I were very happy about because there was nothing in the world that would’ve made me more happy in that moment than to have her proven wrong. Which she was.
The whole article is a case study in stress, distrust, and legalism.
The whole process could have been avoided with one simple action. The cardiologist could have admitted the patient themselves. The only question that needs to be answered here is why they didn’t. And if they had and a hospitalist, as a consultant, transferred the patient to the ICU, they would have had to approve of the transfer.
By the way, the answer to the question above is “yes.” The opinion of a hospitalist with one year of experience carries as much weight as a cardiologist with 25 years of experience. There is no sliding scale in state licensure.
*This blog post was originally published at The Happy Hospitalist*