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Thu Nov 29 14:54:58 GMT 2007

I think the best way to handle this is to have an evidence-based protocol in place that guides the decision making process. Although this does not completely protect  the physician from liability (what does?) it simplifies and automates to some extent what Dr. Mattox has recommended without requiring a full page note for every patient. Frankly that requirement would only work if 1. your volume was very low or 2. you have residents. 

Bill Bromberg

>>> <KMATTOX at aol.com> 11/28/2007 9:21 PM >>>

In a message dated 11/28/2007 8:14:04 P.M. Central Standard Time,  
castill at eng.usf.edu writes:

This  opens a can of worms then:  you don't scan them and they possibly 
sue  you for a missed injury; you scan them and they possibly sue you 
because  of cancer.  Now  what?

You MANDATE that prior to a CT being performed, the ordering physician must  
write a progress note clearly stating the EXACT reason the CT was being 
ordered,  the probabilities as to what might be found, and just what change in 
therapy  that each finding might have on changing the course of treatment if and 
when it  is discovered, AND list the many possible VOMITs which are known to 
exist with  this particular CT and what one is going to do when there is a 
disagreement  among the various specialists on interpretation of the VOMITs.  

k

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