How long do you give specialists to call back and what is your plan of action with no response. This has come up at multiple sites I've been at. I'm talking about the bigger stuff... ie stroke, surgical trauma, stemi etc. Do you page another doc that is not necessarily on call? How long do you wait before you transfer a patient to another facility? A few examples I've seen are stab with free fluid in the belly- no call back 45 min, stroke- no call back multiple pages 2 hours.
Specialist Call-Backs
- Thread starter joeDO2
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I'm a resident, but the rule at our hospital is that they have 1 hour to see the patient (not give recs). Most or the time, people can meet that.
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If it's a resident I call up the chain, i.e. the chief or attending. If it's anot attending, I start calling people who aren't on call. This comes up very rarely on my system, but sometimes someone "doesn't hear the pager."
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So, you're telling me that you have CVA, penetrating trauma, stemi's at multiple hospitals where you can't get trauma, cards, neuro to respond in the ED? You're either prone to extreme exaggeration, somehow out of the communication loop interfering with your interpretation of events or quite possibly in the most irresponsible and dangerous hospital system known to man. It's def a place I would never work.
Yes, sometimes there are delays in acute cases but it's more of a case by case and basis each with individual circumstances dictating how I might respond. In general, you do whatever is best for the patient, even if that means pissing people off in the process.
Are you a med student? Resident? I have a hard time believing you are an attending choosing to work in that environment.
Yes, sometimes there are delays in acute cases but it's more of a case by case and basis each with individual circumstances dictating how I might respond. In general, you do whatever is best for the patient, even if that means pissing people off in the process.
Are you a med student? Resident? I have a hard time believing you are an attending choosing to work in that environment.
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Also how do your calls work? Is someone calling these for you or do you have to call them yourself? At my hospital the clerk will try to call/page them 3 times within an hour. At that point I can call their direct cell phone or find someone else to consult.
That is crazy that any hospital would be waiting for hours for a call back for a stemi or stroke. Your metrics would be terrible for your hospital if it takes hours to get a consult for these nature of consults. At my hospital they actually have a "heart alert," "trauma alert," "airway alert," and "stroke alert" that go on the overhead speaker/Stat paged (similar to a code blue) to get consultants there asap.
Also I find it interesting that when there are two competing groups for one specialty they both tend to call back quickly. If one starts to become slow at returning calls guess who will end up getting the majority of the consults?
That is crazy that any hospital would be waiting for hours for a call back for a stemi or stroke. Your metrics would be terrible for your hospital if it takes hours to get a consult for these nature of consults. At my hospital they actually have a "heart alert," "trauma alert," "airway alert," and "stroke alert" that go on the overhead speaker/Stat paged (similar to a code blue) to get consultants there asap.
Also I find it interesting that when there are two competing groups for one specialty they both tend to call back quickly. If one starts to become slow at returning calls guess who will end up getting the majority of the consults?
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I have them paged/called every 10 minutes until they call back. After a couple of these I have the clerk call their home, clinic, the OR, every number we have listed for them etc. I start calling their partners at about an hour.
But STEMI/Trauma/stroke etc? I agree that's completely intolerable. Now that I've been on the hospital medical executive committee, I'm just going to start writing up these docs that don't call back. You've got to have a paper trail if you want someone to lose their privileges for crap like this. It's surprisingly hard to take them away. Now, if the guy calls back all apologetic (paper broken, mother died, running a code etc) then sure, I'm not going to write them up. But if they call my partner in the morning to complain that the ER paged them 13 times last night (when they were on call and not calling back), screw em, it's time to do an incident report.
But STEMI/Trauma/stroke etc? I agree that's completely intolerable. Now that I've been on the hospital medical executive committee, I'm just going to start writing up these docs that don't call back. You've got to have a paper trail if you want someone to lose their privileges for crap like this. It's surprisingly hard to take them away. Now, if the guy calls back all apologetic (paper broken, mother died, running a code etc) then sure, I'm not going to write them up. But if they call my partner in the morning to complain that the ER paged them 13 times last night (when they were on call and not calling back), screw em, it's time to do an incident report.
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I wish they wouldn't call back for CVA.
Then I wouldn't have to argue about why TPA is a bad idea.
Then I wouldn't have to argue about why TPA is a bad idea.
Student. Not all at the same place, different states, different hospital types. Only one instance at each institution. CVA that was 2 hours was due to 2 other acute CVAs happening in the same system with one person covering. Trauma was at a non trauma hosp who wanted gen surg to stabilize before xfer and didn't hear pager. Not something that's going to occur regularly but since it came up a few times already in my short 5 months of EM I was curious.
