This is a case of failed expectations. See the patient expects the ER doctor to properly diagnose and treat a routine illness. The ER doctor has expectations of ruling out anything that might be life or limb threatening and then shipping you off to another doctor who performs routine care.
One of my favorite docs told me that he only had to answer two questions.
- Sick or Not Sick
- If Sick - to whom and where does the patient get admitted.
- If not Sick - to whom and when does the patient follow up and what do I need to give them in the meantime.
The ER is the nuclear bomb of medicine. We don't have any ability to operate discretely. It is all blinding furor, splattering body fluids, and hastily thrown together cocktails of pharmaceutical yumminess. Does that cover a gunshot? Yeap. Does it cover a heart attack or stroke? Yeap. Does it cover your cold that just won't get better? Nope. Sure, we can splint that broken one and give you some "Scooby Snacks" but we don't actually deal with it at all. Your ortho doc will do the treatment and get you better.
Stabilize those who are at imminent risk until the proper doctor/surgeon can see them. That is what we do. Really, that is all we do.
The poor ER doctor is part gynecologist, orthopod, cardiologist, plastics, gastro, pediatrician, psychologist, intensivist, infectious disease, and family practice (I am sure I missed a few). It is no wonder that they are the masters of none of these fields. Those are entirely separate fields of medicine. Would you expect your shrink to deliver your baby? Why expect the ER doctor to tell you why your back has been hurting for 2 years despite seeing 15 specialists?
Sick or Not Sick... That is what your ER is striving to determine. God help us when we are wrong on that one.
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