This Patient Really Belongs on Your Service

Commentary by a Doctor of a Kind Different From Your Kind

Hi.  I’m really sorry to be waking you at an hour such as this one, but there is a problem which I believe requires your immediate attention.  You see, those scads in the Emergency Department have called upon me to admit a patient who, in reality, belongs on your service.

Allow me to elaborate.  The patient’s medical history is quite complex, and includes several illnesses of the type typically treated by your kind of doctor.  You see, doctors of my type have difficulty providing adequate care for diseases like these, whereas doctors of your kind are accustomed to patients of this sort.

Yes, it is true that doctors in my specialty did technically graduate from schools where medicine is taught, but doctors in my field do not know very much about this patient’s diseased organ systems or body parts.  On the other hand, doctors of your specialty typically know a great deal about those organs and body parts, and therefore I believe you are better qualified than me to care for this patient.

What’s that?  The patient’s chief complaint is of a kind treated almost exclusively by my variety of doctor?  Don’t worry.  My team will guide your team’s management of the problem by distantly following the patient as consultants.  You will know we are true to our word when you see our hastily-scribbled one-line notes in the patient’s medical record.  And, rest assured, we will make sure the patient receives a visit in our clinic, should it become evident that we must continue to manage the problem after your team has written and signed his discharge summary.

Look, I realize that this is an inconvenient time to be admitting this completely-appropriate patient to your service.  And I really appreciate it, in a totally sincere way.  It’s just that, although doctors of my kind typically work shorter hours and carry fewer patients than doctors of your ilk, I think the patient would be more satisfied with the care and individualized attention that your kind of doctor is likely to provide.

Allow me to share an anecdote which will conclusively demonstrate why this patient would be better served by your kind of doctors.  Once, I had a patient similar to this one, who was mistakenly admitted to my service.  Although I provided excellent care for his chief complaint, I am sorry to say that his other medical problems did not receive ideal management, and one of them worsened to the point that your team was consulted to treat it.  A narrow miss, I’d say!  Clearly patients of this variety are better served by doctors of the type that you are.

Really?  You simply refuse to admit this patient despite his clearly belonging on the service which is yours?  Well, I suppose that’s your prerogative.  Perhaps, in that case, we can both agree on the next best option: let’s get him admitted to medicine.