Another small rant before I continue my story. "Dr. Miller, your pt. is on the table and ready!" This is the page I got this morning while making rounds on the inpatients in one of our hospitals. I apparently was supposed to to a cardiac catheterization procedure on one of my partners patients who had never spoken to me about this gentleman and the indications for the procedure let alone let me know it was being placed on my schedule. Now granted, a diagnostic coronary angiogram is not a major procedure, but knowing that it was ordered on an 84 yr.old man with exertional chest pain and syncope and an echo showing moderate/severe aortic stenosis would have been useful information when I walked into the lab. Do you think the patient and his family knew that I was walking in "blind"? Of course not. To save face I absolutely lied to them telling them I had discussed his case with my partner in detail and understood exactly why the procedure was to be done and that I had agreed with his recommendation. My partner is a non-invasive cardiologist and therefore does not perform catheterization procedures yet he is the person who obtained informed consent on this elderly man. Is that right? How can he get permission to do an invasive procedure on a person that he doesn't perform and that will be done by another individual they haven't met while he's in another state at a conference?
I understand that the path of least resistance for my partner after seeing a patient like this in the office is to simply check the box that says diagnostic left heart catheterization/coronary angiography on our discharge router and move on to the next room. But what about the patient involved? Shouldn't they get just a little more personal attention and know that if another provider is going to be involved in their care that they were well informed? Wouldn't my partner want to meet the person doing this same procedure on his wife or mother? This guy didn't put up any fuss so he never had a chance. I felt like such a fake and almost as if I were victimizing someone who due to his age and perhaps limited sophistication was being taken advantage of.
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