Ok.
Here is where the MDs post some simple clinical questions for the nurse practioners...
What's a practioner?
I know I'm only an RN, but...
Couldn't resist, as a doctor (could have been a pre med) threw out some grammar smack (regarding ellipses) down on me and others a while back, and the tone of his post was a gratuitous dig at nursing.
So the irony was too funny to pass up, sorry
Going out on a limb here, but I've got my own take on any scenario you would give out.
I would submit that physicians would differ on your above scenario.
Now, my experiences (20+ years as an ER RN in 10+ ERs in two states) are completely anecdotal, but, I have discussed (with countless ED docs) how management of the same patient will differ amongst themselves (no noctors, just docs)
What I have noticed, is that it depends on many factors (where one trained, with whom one trained, if one has been 'burned' by a zebra or just burned, which ED in which one works, etc.)
For example, I was working at an ER in a retirement community. A pt came in one day with L arm pain/numbness. Pt had a significant cardiac HX, so (based on our protocols, written by the docs) I ordered an EKG, as the doc was tied up.
The EKG tech came down within 3-5 minutes, and the doc came out of the room from a pelvic. He stopped the EKG tech, did a brief HX on the pt, and dc'd her with ulnar neuropathy, no labs, no EKG.
I certainly defer to his education and expertise. (And I think some of these protocols are waaay overused by nursing)
My point is: he was questioned by his partner (another MD), words were exchanged, and the pt's dispo remained. They disagreed with what seemed like a slam dunk justification for an EKG.
Some docs will order a CT based on 'X' chief complaint, others won't. I may be an RN, but I have seen so much variability (I get that I haven't been to medical school and that I don't have the knowledge base to know all of the differentials for 'proper' course of treatment.)
The last ER job I had ('famous peds hospital in Phoenix)
every baby <3 months, with a (stated) history of a fever (afebrile upon presentation), got tapped and labs drawn immediately. then
before a single lab result ever came back, within minutes, we were giving two ABX and and one antiviral.
In my current hospital, the ED doc will admit the kid immediately, we usually don't draw labs in the ER, and things take more of a different course, depending on ______________ (with the rural/community pediatrician commanding the ship; meanwhile, back at the teaching hospital there are two attendings, hosts of residents, etc. and lots of obscure tests ordered)
I'm just saying that I've seen docs question other docs in the ER from time to time (of their management for a particular CC or condition)
I think even seasoned physicians would differ on the 'proper' course of treatment, as we can't see your patient and there is not enough history attached to your scenario.
I don't like solo NP/PA treatment either;
Look at some scenarios proposed on other parts of this board (by docs, for docs). The courses of treatments offered (by seemingly very seasoned docs) differs between the varied responses.
Your point is well taken, but not very fair and applicable to the real world.
Pardon my rambling and derailment, but I think one doc's
routine choice of treatment, is another's idea of looking for a zebra.