The problem of admission diagnoses – a guest post

I received this response to a recent post. It is so good that I wanted to share it – so with Dr. Thomas Nielson’s permission I have. He makes the important point that the rush to LABEL the patient with the diagnosis has major unintended negative consequences. He says it so well that I encourage your reading and comments. Thank you for this post. This is a problem that occurs from time to time, and I believe that the current system in place for admissions is a large part of the problem. We are asked to diagnose people in the emergency department because we need an “admission diagnosis” so that we can make sure that we meet “admission criteria”. The people in hospital administration who require this have never taken care of patients themselves, and they have no idea what they are talking about. There is a disconnect between administrative types and doctors, and I do not know how this can be solved in our current system. Example: Patient presents with AMS and is found to have a massive acid base disorder in the ED. What is the diagnosis? I have no idea! I need to admit the patient to the hospital and run a bunch of tests before I can tell you what the underlying problem is. Is it ethylene glycol poisoning? Is it their renal failure? I don’t know. The current system puts the cart before the horse in requiring an admission diagnosis. What happens is some random diagnosis is given to the patient so that we can get them into the hospital. Unfortu...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs