The Last Doctor is Always the Smartest

Twice recently, I’ve been privy to patient complaints about emergency department “misdiagnoses” when patients have gone to follow up appointments with their physicians. One case involved a young girl who had a rash. The rash was preceded by a low grade fever in the days prior, began on the chest and spread outward, and had the classic appearance of a viral exanthem. The girl’s parents weren’t happy with that diagnosis. They believed that the girl was suffering from an allergic reaction and that she needed antihistamines and steroids. The doctor explained that the rash was not an allergic-type rash and that she didn’t appear to be ingesting anything that could have caused an allergic reaction. The family left unhappy. The following day, the nurse manager gets a phone call from the patient’s irate mother. During a follow up appointment the following day, the patient’s pediatrician stated that the rash was “absolutely” an allergic reaction and immediately started the patient on Benadryl and prednisone. Oh, and the patient also had an ear infection that the emergency physician missed, so she was started on amoxicillin as well. The money quote for that call was “What type of doctors do you have working in your hospital, anyway?” Of course, the natural course of an exanthem is that it will go away after a couple of days. So right after the patient starts taking the medications for her “allergic reaction,&...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: Tags: Patient Encounters Source Type: blogs