I don’t like confrontation. I strongly feel that most things can and should be sorted politely and calmly, and that everyone should be reasonable about (almost) everything. As such, I really don’t like having to get bitchy on the phone. Today I have had to be, and I’m grumpy about it.
Listen, specialists. I know that you are specialists, and what is barn-door stupid-obvious to you may not be such to me. You may see traumatic spinal fractures in young people or fast AF with bundle branch block on a daily basis, but I do not. If I ask for you to come and review a patient because I am worried about them, please stop assuming it is because I am out to make your day more difficult or because I am lazy – it is because I need your opinion as a specialist. If I am happy with advice over the phone I will tell you this. Some things, however, are not amenable to telephone diagnosis and in these cases please don’t make a fuss – come and see the patient. By all means ask me to talk to my consultant first, or another specialty if you feel they are more appropriate, but if they also think you need to come and review the patient then just do it. Ultimately we’re both out for what’s best for the patient, and right now what’s best for the patient is that you come and review them.
That, and we both know that we can either have a professional, courteous conversation on the phone or my consultant can call you. You then get your consultant involved, everyone gets angry, and in the time it took for all of that to happen the patient could have had a plan in place.
And wha’d’y’know, you admitted the patient and have arranged an MRI spine. Guess it’s good I didn’t just send them home, as you so politely suggested down the phone. I know the hospital opinion of ED is that we’re all idiots. We’re not.