Admission orders

Letters

CJEM 1999;1(2):92

To the editor:

I read with interest the commentaries in CJEM1-3 regarding emergency physicians (EPs) writing admission orders.

Does anyone think that, just maybe, writing admission orders (and having the last word on whether a patient is admitted) might reduce our legal risk? Does anyone think that the EP is in an excellent position to write comprehensive orders? Does anyone think that writing admission orders and determining patient care is a valuable skill for emergency physicians to maintain? In many cases, EP admission orders facilitate timely patient care and help alleviate emergency department (ED) congestion. Beleaguered ED nurses, as well as patients, families and relatives, appreciate prompt decisions and dispositions.

In our busy ED, emergency physicians routinely write admission orders. It is not a waste of time. It allows the EP one last opportunity to review the patient, collect his or her thoughts, and initiate timely care. Maybe, except in specialized situations like intensive care cases, emergency physicians should write all admission orders, unless consultants, residents or family docs do so as a courtesy to us.

I wonder who's really at higher medico-legal risk: emergency physicians who write orders? Or those who don't?

I hope this controversy rages on for some time to come.

Michael Hebb, MD
Dartmouth General Hospital
Dartmouth, NS

References

1. Shuster M. Who should write admission orders? CJEM 1999;1(1):21.
2. Socransky S. Admission orders [letter]. CJEM 1999;1(1):19.
3. Robson R. Admission orders [letter]. CJEM 1999;1(1):19-20.