PHILADELPHIA, PA – Dr. Rajiv Katar, a physician at Philadelphia General Hospital, was astonished on Friday to receive transfer records that included a discharge summary – and only that – lacking the usual several-hundred-page accompaniment of nursing notes and medication administration records. “It was the first time in my 25-year history as a physician that I received such a clear explanation of what happened with the patient.”
Dr. Katar usually receives a large amount of papers in typical transfer requests that are “interesting but useless.” “I typically have to sift through the medication logs of when subcutaneous heparin was given and the nurses description of the patient’s demeanor to find the information I am looking for… it’s kind of like an Easter egg hunt.”
Dr. Katar states that the process of finding the information is exciting when he actually finds what he is looking for and has never had the information provided directly. “It was refreshing to have to receive only two pages with most of the relevant information but a little unsettling not knowing how many units of subcutaneous heparin the patient had been getting.”
The patient involved was being transferred by air ambulance for one-time episode of chest pain that had already resolved. Since the transferring hospital could not find a cause for the chest pain, they transferred the patient to Dr. Katar at Philadelphia General Hospital, who admits that he too is no closer to finding the cause of the chest pain and will likely transfer the patient to another hospital for third opinion.
“Who am I to discharge this patient home without an explanation of their chest pain? Maybe a third hospital will be able to figure this medical mystery out – third time’s a charm!” He also admits that he finds it difficult to just fax this discharge summary to the third hospital and will likely include a large-number of mostly irrelevant pages in his records transfer. “What if they need to know when the patient ate lunch on the third day here?”