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Originally Posted by ERCougar
I see what you're saying, but here we're talking about a cost to the patient/society versus a cost to me. Unless you're advocating we just admit every patient to the hospital, in order to never miss a serious event. But even that's not 100%, as you need to then follow up with some sort of stress test--yup, more radiation and possibly more nephrotoxic dye--I don't think that's really beneficial to the patient either. Ideally, yes, we should always come down on the side of the patient, but then ultimately, we'd all be working for free, right (or at least a minimal subsistence to survive on)? The other problem is that those who are trying to "do the right thing" are getting forced out of practice (witness OBs in PA, ER docs in FL, neurosurgeons/orthos refusing to take call for liability reasons, etc.).
I think an expert panel would alleviate a lot of the issues. Europe has it, Canada has it, we don't. Why not?
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That's why there are practice guidelines. Experts look at the research and come up with practice recommendations. You document your reasoning in your note, pointing out why you believe that your decision was in the best interest of the patient.
Psychiatrists have to make life-and-death decisions all the time in hospitalizing or not hospitalizing suicidal patients. It's impossible to make correct decisions all the time, the best they can is make an informed decision and document why they believe the decision they made was the best for the patient.