Dr. Ellie Goodmedicine, an attending physician in the Department of Emergency Medicine at New York City Hospital, stunned the department’s residency program by admitting a patient to the hospitalist service while the residents were attending a noon conference lecture.
“No attending physician has admitted a patient without substantial resident support and assistance for the last three years since we moved to the electronic medical record system and established a new admitting protocol”, explains Chief Resident Dr. Handholder. “The process is actually very complicated and it can take years of practice to successfully maneuver a patient into a hospitalist’s care.”
Prior to this incident it was assumed that attending physicians were incapable of admitting their own patients to the hospital, presumably because the mental effort required to juggle unrelated admitting protocols proved to be greater than the satisfaction of completing the admitting process in a timely fashion.
“I think the attending physicians are happier with the concept of a patient boarding in the ER while they wait for the resident to complete a 35 centimeter laceration repair than they are just going through the admission process because it’s so unbelievably painful”, explains intern Dr. Ivy Leaguer. “In fact, I can’t hardly pull of an admission on my own yet without asking for help!”
Dr. Goodmedicine was observed to complete a disposition note on the electronic medical record with a grin on her face, enter final diagnoses compatible with ICD-10 billing phrasing as her grin became a slightly contemptuous smirk, completed the outpatient medication reconciliation process with a deft snap of the mouse and without a glance at the long list of medications randomly compiled by the triage nurse, contacted the patient’s primary care physician and two specialty consultation services to ascertain the correct admitting service without shedding a tear, placed the admission order in the computer while updating the patient’s recorded weight, confirming their gender and noting their code wishes, HIV status and isolation requirements, and then signed the patient out to the appropriate hospitalist, placing the handoff note in the electronic medical record with a masterful flourish.
She then collapsed into the only nice swivel-chair that hadn’t been taken by the department’s clerks and sighed a deep and contented breath of relief and self-congratulatory amazement.
Following this event, Dr. Goodmedicine was then noted to treat herself to a cappuccino, which she enjoyed at the nurses’ station in observance of the new Joint Commission Recommendations recommending the full and unobstructed caffeination of health care providers.
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