When Lung CT is ordered?

[Pejmaan]

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Seems this scenario is more wierd than some could believe. They keep talking about ED routine and CXR is needed before anything. Money and relationship stuff. I guess that's enough to prove that this thing is wrong enough. That's it:A healthy person with bronchitis were told to have non-con CT and nobody knows why. Is this that hard to solve the scenario out of routine and abstractly try to rationalize the doctor's order?

 

[illegallysmooth]

Seems this scenario is more wierd than some could believe. They keep talking about ED routine and CXR is needed before anything. Money and relationship stuff. I guess that's enough to prove that this thing is wrong enough. That's it:A healthy person with bronchitis were told to have non-con CT and nobody knows why. Is this that hard to solve the scenario out of routine and abstractly try to rationalize the doctor's order?

No, you haven't proven a single thing. You haven't given enough information for us to figure out why the CT was ordered. You're making huge assumptions on "money and relationship stuff" with zero evidence.

 

[Pejmaan]

No, you haven't proven a single thing. You haven't given enough information for us to figure out why the CT was ordered. You're making huge assumptions on "money and relationship stuff" with zero evidence.

Sure you have had enough info if you had time to go through all of posts, except let me see: the birth date and I'm sure you gonna have taught time to figure out what "abstract" and "rationalize" mean!? and I'm gonna sent out the evidence to the court dude. I'm not gonna post it here for sure

 

[illegallysmooth]

Sure you have had enough info if you had time to go through all of posts, except let me see: the birth date

How long has he had the problem? Did it come on suddenly or gradually? Any fevers? How severe was the shortness of breath? Did it change with time of day or body position? Any chest pain? If so, what kind of pain? Where? What did it feel like? Did it change with breathing? What did the sputum look like? How much sputum? What were his vitals? O2 sat? What about his past medical hx? Weight? Medications? Family history of bleeding disorders or blood clots? Any relevant social hx? Sick relatives? Travel? Had he been sick like this before? Physical exam findings? Crackles? Wheezes? Decreased breath sounds? Areas of dullness or flatness to percussion?

See what I mean?

 

[45408]

Since you are the smartest of all. I guess you had it by the first post

No, it wasn't until you made the implication about doctors ordering tests for poor patients to foot the bill.

 

[VenusinFurs]

OP: regardless of whether you are genuinely curious from an academic standpoint or are worrying about whether this is "standard of care" from the point of view of a patient/ loved one, we can't tell you why the doctor did what he did because we weren't there and we have no way of knowing what his thought process was. Anything here is just speculation. Doctors can't order unnecessary tests for monetary gain; he thought it was necessary. If you want to know why he did it you'd be better off asking him.

 

[Pejmaan]

How long has he had the problem? Did it come on suddenly or gradually? Any fevers? How severe was the shortness of breath? Did it change with time of day or body position? Any chest pain? If so, what kind of pain? Where? What did it feel like? Did it change with breathing? What did the sputum look like? How much sputum? What were his vitals? O2 sat? What about his past medical hx? Weight? Medications? Family history of bleeding disorders or blood clots? Any relevant social hx? Sick relatives? Travel? Had he been sick like this before? Physical exam findings? Crackles? Wheezes? Decreased breath sounds? Areas of dullness or flatness to percussion?

See what I mean?

a week, suddenly, no fever, not very sever but using mask could heal, body position (in bed), a bit of chest pain middle upper part, not a sharp pain, didn't change with breathing, sputum normal except for infection and blood in it for a few times, not much, all normal vital, O2, nothing unusual in history, not weight loss, generally healthy person in past, no family disorders, all other things negative and normal, lung sound ok, blood pressure ok and no other abnormalities.

 

[illegallysmooth]

a week, suddenly, no fever, not very sever but using mask could heal, body position (in bed), a bit of chest pain middle upper part, not a sharp pain, didn't change with breathing, sputum normal except for infection and blood in it for a few times, not much, all normal vital, O2, nothing unusual in history, not weight loss, generally healthy person in past, no family disorders, all other things negative and normal, lung sound ok, blood pressure ok and no other abnormalities.

You're telling me that an oxygen mask helped his shortness of breath but his pulse ox was normal and vitals were normal? That doesn't make sense. Do you actually know what his vitals were or are you just assuming?

 

[Pejmaan]

OP: regardless of whether you are genuinely curious from an academic standpoint or are worrying about whether this is "standard of care" from the point of view of a patient/ loved one, we can't tell you why the doctor did what he did because we weren't there and we have no way of knowing what his thought process was. Anything here is just speculation. Doctors can't order unnecessary tests for monetary gain; he thought it was necessary. If you want to know why he did it you'd be better off asking him.

Thank you smarty for your guideline, Obviously they can order unnecessary tests unless you are smart enough not let them to. I asked him and he said that was my diagnosis! so what if he is wrong with his diagnosis? And I'll tell you about his though process and I know there will be lots of complains and nobody gonna believe it: They guy is anxious with the blood, doctor finds out everything is normal, he knows he has to treat infection with antibiotics and order a CXR. but surprisingly he replaces CXR with non-con CT and tells the patient this method is more accurate than CXR!! since CT is normal with hemoptysis, nobody will complain!

 

[Pejmaan]

You're telling me that an oxygen mask helped his shortness of breath but his pulse ox was normal and vitals were normal? That doesn't make sense. Do you actually know what his vitals were or are you just assuming?

It was not an emergency case, I just meant regular mask not oxygen

 

[greatnt249]

Thank you smarty for your guideline, Obviously they can order unnecessary tests unless you are smart enough not let them to. I asked him and he said that was my diagnosis! so what if he is wrong with his diagnosis? And I'll tell you about his though process and I know there will be lots of complains and nobody gonna believe it: They guy is anxious with the blood, doctor finds out everything is normal, he knows he has to treat infection with antibiotics and order a CXR. but surprisingly he replaces CXR with non-con CT and tells the patient this method is more accurate than CXR!! since CT is normal with hemoptysis, nobody will complain!

Regardless of whether the CT was appropriate (TBH, I'm having a hard time comprehending what you're trying to say), the doctor did not profit from ordering the CT over the CXR.

 

[illegallysmooth]

It was not an emergency case, I just meant regular mask not oxygen

Excuse me? A "regular mask," helped his shortness of breath, not an oxygen mask? And you didn't answer my question- do you know his vitals or not?

 

[deleted103644]

Excuse me? A "regular mask," helped his shortness of breath, not an oxygen mask? WTF is a regular mask? And you didn't answer my question- do you know his vitals or not?

Clearly he doesn't. Can we let the thread die now?

 

[DrMom]

Closing.

SDN is for those in medical training to discuss training issues. It is not for medical advice or evaluation of case management by physicians.