On Call Dilemma

emergencyTypically my call weekends are light. I don’t get a lot of messages. Saturday there was one remarkable only in my inability to do much for the caller. My associate’s elderly patient was in the ER, sent there by her physician. He is 94 and was falling more lately, had reduced appetite, just didn’t feel well with occasional episodes of shortness of breath. His daughter called because they were “40 patients deep” in the queue and she wanted to know what could be done to improve the chance that he would be seen more expeditiously. I thought about it. I certainly understand why she was concerned about her elderly father sitting on hard chairs in the emergency room with goodness knows what illnesses surrounding him. At the same time it didn’t sound like there was anything emergently wrong, as opposed to urgently.  He might have a pneumonia or urinary tract infection, so common in the frail old patient. Was it  appropriate to try to push the emergency room to see him ahead of the other 39 people who no doubt also felt that their problems were of utmost importance? I explained to the daughter there was no certainty anything I said would get her father seen more quickly and she responded that her experience was when a physician called things got done. Sometimes that is true if I have knowledge the ER is lacking as to why a patient is seriously ill. But I didn’t really have that. How quickly does one wear out their welcome with the ER if I cry wolf? On the other hand the patient is 94, sounds frail and certainly was at risk to sit in emergency room for several hours. My own mother is not too far from that age so I intimately understand the daughter’s concern. What was the right thing to do?

What would you do?

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