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Fri Oct 9 14:44:17 BST 2009

I dearly miss Dr. Eric Frykberg's pithy contributions on this topic, and
refer readers to his work in Jacksonville in the 90's, which clearly
demonstrated both clinical and financial benefits by deep debridement of
"trauma panels" and other habitual diagnostic tests.

(What so many clinicians attribute to "defensive medicine" might as
truthfully be described as intellectual laziness.)

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
Sent: Friday, October 09, 2009 8:17 AM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: Gross, "Mattox to participate in study"

Dr. Mattox makes a most excellent and crucial point:
>
>    In
> my view, NO CT  should ever be ordered unless there is a clear  
> indication as
> to what the person  ordering the tests expects to learn, and how that
> additional new knowledge, over  and above the existing and original  
> plane x-ray
> demonstrated, will alter  decision making and treatment.   If such a  
> progress
> note were required  for the reflexly applied ordering of CT scans, I  
> do
> believe that over 75% of all  current CT scans and CTAs, etc. would  
> be stopped
> over  night.
>
> k
>
Just change "test" for "CT" and it should be a universal medical  
truth. Every clinician should at least go through the disciplined  
intellectual work of this before ordering any test. The only pearl I  
have to offer young docs is perhaps the corollary: Never order a test  
you don't want to know the answer to.

So much pain would be avoided.

Rob Smith

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Gross, "Mattox to participate in study"