--- YES! In a word, "Yes" is the answer I give whenever that question is
asked appropriately.
I would be grateful for your examples of way of thinking, especially for the
fell-on-outstreched-hand-pain-in-the-snuff-box-normal-Xray-at-presentation
kind of patients.
--- Just get everyone to think and say:
"Clinically you have a scaphoid fracture. This means that, once I have
finished with you, this will be your diagnosis. I will now do an X-ray to
rule out any urgently treatable displacement or dislocation and/or any other
condition. After the X-ray, your diagnosis will still be a scaphoid
fracture, perhaps with some additions. Therefore, unless I need to refer you
for urgent treatment, your wrist will be placed in a
cast/backslab/splint/whatever-locally-done."
Saves confusion among practitioners and patients...
-----
Also, what is your review time, in what a review consists and for how long
you review them?
--- I don´t review them. Send them to whomever will be able to operate on
them in your hospital should they have needed it... I prefer not to see
anyone once they have no urgent need to see me. Of course, there are
millions who come anyway because they THINK they want to see an Emergency
Physician, but I´m damned if I´m adding to this pile anything other than
what REALLY interestes me to see again... Whomever they end up in the clinic
with should decide when they want to see them (my experience is that some
say 10 or 14 days, but most say "next clinic for that on-call ortho team").
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