Page 56 - Hospitalists - Risks When You're the Doctor in the House (Part One)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

• If the patient refuses your advice or recommendations,

document the refusal in the record and convey it to the
consulting physician.

• If your plan involves continued treatment but you are

signing off of the case, be sure you communicate with the
referring physician to ensure the patient can obtain the
appropriate treatment.

• If the referring physician has asked you to assume the

care of the patient, indicate in writing whether or not you
accept.

In all instances, clarify the role of each physician in the patient’s
care.

C A S E S T U DY

Mr. Richardson, a 71-year-old male patient with multiple

health issues, was admitted to the hospital for treatment of
chest pain. Mr. Richardson had a medical history of obesity,

sleep apnea, hypercholesterolemia, hyperthyroidism,
arthritis, and ulcers, as well as a surgical history that

included back surgery, thyroidectomy, and transcatheter
intravascular stent placement. Dr. Ford, an interventional

cardiologist, diagnosed Mr. Richardson with paroxysmal
atrial fibrillation. Dr. Ford ordered nuclear stress

testing, which was unremarkable, and transesophageal
echocardiography (TEE), which demonstrated no

evidence of atrial thrombus.

Dr. Ford initially planned a cardioversion at the time of

the TEE, but Mr. Richardson had numerous episodes of

paroxysmal atrial fibrillation with spontaneous conversion

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