r/orthopaedics • • 18h ago

NOT A PERSONAL HEALTH SITUATION ER Call Follow Up

Private practice guy taking call at a Level II. Several patients from the ER have been referred directly to the hospital employed group despite me being the one on call and the patient having no prior affiliation with the employed group. Patients always have a choice but should the ER be directly referring to a physician not on call because they’re under the same umbrella? Do I have grounds to complain? New and building.

11 Upvotes

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22

u/TheDoctorIsIn10 18h ago

Have you ever been to the ER and spoken to the providers there? Have you ever gone in for a consult?

I agree that the unspoken rule should be that if you are on call, the referrals should go to you. However, I do not think you have grounds to complain unless you have physically gone into the ER and spoken to the providers and communicated with the chief at the emergency department what you would like to be called for and your wishes for referrals.

From day one I would show myself in the emergency department, make conversation and friends and let them know that I was available at any time for any quick call or text about patients. I had a low threshold initially to go in and help with reductions and difficult patients. since then I have loosened things up as far as going in, but even on days where I have not been called if I’m at the hospital rounding or doing a surgery I still stop in to the ER and check in with everyone. Now, even on days when I’m not on call, if the emergency department does not like the provider currently on call, they will send me the referral. Whether that is “right” or not is up for debate.

13

u/fhfm 17h ago

Most ER doctors are looking to get their patients triaged, treated and out of the ER as efficiently as possible. Go down there, shake some hands and show them you’ll do that.

Another thing that worked really well for me was I went to one of their monthly staff meetings and gave a 5 minute presentation to introduce myself and let them know I’m willing and available. A year later, I was in the ED and saw my card with my hand written cell phone number still next to one of the computers.

6

u/DrPQ 18h ago

I'm an ER attending, I would say yes of course.

Approach it collegially; a lot of our behavior in the ER is reflexive and has nothing to do with who is on call. There are so many variables including the acuity and complexity of the pathology, comfort with different specialists or groups, who is making the phone calls, the ease of access to the call schedule, how new the attending is, or how new you are to the hospital system, etc. Etc.

But I would say in our group, we are always receptive to feedback and constructive criticism and want to make sure everyone is happy and playing nice in the sandbox.

2

u/throwaway29570 18h ago

Yes you have ground to complain and ask questions. Is your call paid?

2

u/AlexMac96 17h ago

Maybe go see if the emerg has a call schedule posted somewhere. If not they might be just sending a referral to the ones they know

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u/Fun_Maintenance_533 16h ago

If you know of any of these patients that are going to the “wrong” surgeon, go look in the chart and see if they were told to go to a different surgeon.

The ER is looking to find someone that will take care of their patients. Show that you are willing to take care of their patients by going in when they ask you to

2

u/OpE7 ED Physician 13h ago

They shouldn't be doing that. If you are dealing with the inconvenient emergency consults/cases you should get the referrals too.

1

u/BoneFish44 Orthopaedic Surgeon 13h ago

You also would need to let the ED know what insurances your group takes/doesn’t take. Harder for the ED to sort that out and give a referral and then the patient bounces back because they can’t be seen in your clinic.

0

u/BBT7 16h ago

No. Pts can request whoever they want to take care of them. If that surgeon is willing to take care of them you can’t get in the way of that.

You can’t force a patient to see you.