Getting all political/medical and self-rightous

http://www.washingtonpost.com/wp-dyn/content/article/2006/01/06/AR2006010600273.html?nav=hcmodule&sub=AR

"Sharon's physicians defended their decision to transport the prime minister by road from his ranch in the Negev desert region of southern Israel to Jerusalem after he complained of chest pain on Wednesday evening. He was examined by his personal physician, Shlomo Segev, who accompanied Sharon to Jerusalem, about an hour away, although there are hospitals closer to Sharon's Sycamore Ranch."

As a former medical-type person, I realize it is not my place to question a physician's judgment....I don't have their education and I don't have their familiarity with the patient. However, after a decade and a half of working in emergency rooms and on ambulances, I also realize that physicians occasionally make bad calls - and that sometimes it IS ok to firmly, but gently, point out the possibility that they're calling this one badly.

If you're a municipal ambulance (as opposed to a private service ambulance) it's also "ok" to refuse to follow a personal-physician order if you feel the order will place your patient at further risk. Granted, it's a pain in the ass - and you damn well better be sure you know what you're doing and that you have the courage of your convictions and some obscure law and some really shitty patient vitals to back you up, but you CAN do it....you can refuse to transport to any place but the closest medical facility.... in fact, in some areas it's not just a choice, it's a standing order.

I wonder, had it been me driving that ambulance, what I would have done.

I'm glad I never worked with the rich and the famous. I liked my job, I liked my patients, I liked the doctors I worked with and I liked the town I worked in. I liked that only once - when faced with a very similar situation - that my town and my hospital backed me up. I like that the old man lived to eat another Thanksgiving dinner with his family. I didn't like that my driver got punched in the face while trying to explain the "closest facility" rule to grandson-doctor though. I don't think he liked it too much, either.

Private physicians know medicine inside out and upside-down - they know their patients, they know their hospitals and their surgeries and they know all about drugs and treatments and laws and insurance and malpractice and hearts and bones and lungs and skin and chemistries and diseases and assorted illnesses and body-malfunctions. Ambulance people know a very little about all those things...but the one thing they do know is what constitutes an emergency situation.

In my humble opinion, a 77 year old man complaining of chest pain - one who is overweight, has suffered a recent stroke, is scheduled for heart surgery on the very next day to repair a heart defect and is on blood thinners - in my opinion -THAT'S an emergency situation....one you don't want in the back of your ambulance for anywhere near an hour if you can get him to a medical facility much sooner.

That's what helicopters are for.