Why are you here?

{walking into a patient's room}Me: "Hi Mr. Smith, I'm Dr. Gilman and will be taking care of you today in the ER. So, I reviewed your chart, and I don't see any significant past medical history. The nurses tell me you don't feel well. Tell me, what's the matter today?"Smith: "I'm sick"Me: "Okay, but what's wrong"Smith: "I don't f*ckin' know, you're the doctor."I hate, hate, it when a patient doesn't have a chief complaint when they come to the ER.Why are you here? Today? Right now? (i.e. why couldn't this wait until you could see your primary doctor). What changed? What are you afraid of? Specifically, what part of your body is bothering you.My job is to determine if this...whatever it is you have...is likely to kill you tonight, or tomorrow. If it won't kill you (or severely disable you), my job is done. I do not know why your rash won't go away. I don't have the time or resources to figure out why your toenail fungus medication isn't working. I don't usually adjust medications that your doctor has decided are best for you. And I don't write prescriptions for psych meds, viagra, or refill highly addictive meds without good (and I mean a very good) reason. I am not a substitute for your doctor. If you rely on the ER to diagnose cancer, or manage your hypertension...you'll die from complications related to these diseases. You could go to the ER 10 times in 2 weeks c/o abdominal pain, that eventually turns out to be an gastric ulcer or stomach cancer. Do you know when we, in the...
Source: EM Physician - Backstage Pass - Category: Emergency Medicine Authors: Source Type: blogs