Friday, December 29, 2006

Dangers of Dial-A-Diagnosis

Dr Dork was saddened to hear of this tale of unnecessary death in Queensland.

There have been pushes in various Australian states for such "telephone triage" services. At the very best, they are staffed by nurses. Often, by persons with little clinical background in any discipline.

This is very, very dangerous territory.

Any doctor or nurse of reasonable experience knows well that medicine is art, as well as science. That clinical judgement and acumen are acquired through experience. That, sometimes, one can tell that something is just not right at a glance, without being able to put our finger on any objective criterion on which to pinpoint our suspicion...that something is subtly awry.

Dr Dork feels uncomfortable providing telephone advice to a patient he has not seen, and cannot see. He feels this is Bad Medicine.

These "health hotlines" are about bureaucratic cost cutting. A layer of insulation to shield ambulance services and emergency departments. As Dr Crippen and others have discussed in regards to NHS Direct in the UK.

Dr Dork does not know the specifics of what actually occurred in the Queensland case. This is pending on autopsy results.

Dr Dork knows well, however, that an ill wind bodes no good.


Nikeroo said...

So many illnesses so few qualified people with so little time...

The opportunity cost of seeing one patient properly is the number of patients that missed out getting to be seen by a doctor at all.


Moof said...

Our insurance company encourages us to call their "hotline" before making appointments with docs or going to an emergency room ... they also have made a habit of calling me and trying to foist a "patient advocate" on me ... as a "go between" in my relationship with my physicians.

Dr. Dork ... that sort of thing is rampant, and getting worse.

Great post!

Dr Dork said...

Fair call

A patient advocate sponsored by your insurance company *cough cough*

Just a slight conflict of interest, mayhap ? Amazing.

Kind regards

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