CS: labs for the sake of putting labs

[Hoju]

So I was wondering what you all think about putting labs on CS for conditions that don't usually require much of a work up. Say they have a typical tension or migraine type headache. In real life you would likely just write a scrip and send them on their way. On CS would you put labs just to fill in the box? Do they dock you for unnecessary labs?

---

Members don't see this ad.

 

[dally1025]

or to expand this question, what about imaging/procedures? For example, FA has CT head/LP for migraines but I wouldn't do that in real life if the person was young, HPI is a stereotypical migraine but is it better to "order" this stuff even if it is unnecessary?

 

[septoplasty]

Well the cases are presented that they wont give you a definitive presentation that resembles 1 diagnosis. Youll get multiple diagnosis, and you want to always rule out the most serious of them, and therefore order labs.

Ex. Migraine but you could r/u temporal arteritis too.

 

[zstranger2]

or to expand this question, what about imaging/procedures? For example, FA has CT head/LP for migraines but I wouldn't do that in real life if the person was young, HPI is a stereotypical migraine but is it better to "order" this stuff even if it is unnecessary?

Even in real life you still want to rule out pseudotumor cerebri etc. I sense you are an IMG. In America, we do things the right way. DO it right and pass the first time.

 

[dally1025]

Even in real life you still want to rule out pseudotumor cerebri etc. I sense you are an IMG. In America, we do things the right way. DO it right and pass the first time.

Nope, soon to be American grad here that is going into EM. I'm talking about a patient that has a history of migraines (and this headache is just like that), is young, not "worst headache of my life," no focal neuro deficits or papilledema, no history of headaches worse in the morning, not obese etc. During my EM rotations those patients wouldn't get an LP or imaging, simply a headache cocktail and time . Don't get me wrong, most people get scanned or LP'ed but there are some occasions when it's not indicated. There are risks and it costs money. As someone that had a CT that wasn't indicated earlier and a few months later got a bill for $5000 because insurance refused to pay. I think that doing no harm bit includes to a patient's pocketbook. At the end of the day, I'll write it down because it's fake and I just want to pass. So stop with the condescending tone about "in America we do it the right way." Not true, we do it the way that prevents us from getting sued and without regard to the cost. No wonder health care is so expensive...

 

[VenusinFurs]

lolol

I think I put very few labs on several of them.

But I don't know if I passed or not yet so I'll let you know when I found out

 

[septoplasty]

Nope, soon to be American grad here that is going into EM. I'm talking about a patient that has a history of migraines (and this headache is just like that), is young, not "worst headache of my life," no focal neuro deficits or papilledema, no history of headaches worse in the morning, not obese etc. During my EM rotations those patients wouldn't get an LP or imaging, simply a headache cocktail and time . Don't get me wrong, most people get scanned or LP'ed but there are some occasions when it's not indicated. There are risks and it costs money. As someone that had a CT that wasn't indicated earlier and a few months later got a bill for $5000 because insurance refused to pay. I think that doing no harm bit includes to a patient's pocketbook. At the end of the day, I'll write it down because it's fake and I just want to pass. So stop with the condescending tone about "in America we do it the right way." Not true, we do it the way that prevents us from getting sued and without regard to the cost. No wonder health care is so expensive...

Clutch.