Foolhardy advice?


Fam Pract Manag. 1999 Nov-Dec;6(10):10.

To the Editor:

I'm a bit perturbed by Dr. Sanford Brown's recent advice in Practice Diary.

In the June issue, he describes an ER patient with blunt flank trauma and hematuria. While I agree that Dr. Brown (or I) could have provided more efficient service to this patient in the office, I'm not sure I would have omitted the abdominal CT, as he seems to suggest. Passing off the hematuria in this setting could be foolhardy.

In the May issue, Dr. Brown's comments about nutrition seem to reflect a disdain for basic, up-to-date nutritional concepts. I believe our patients deserve better than that.

Author's response:

The patient referred to in the June issue had occult hematuria following minor trauma and did not, I believe, require a CT scan.

The point of the piece was that emergency departments run up big bills on workers' compensation cases, and more employers are now turning to family physicians to see their workers with minor injuries. My advice is that this represents a revenue stream that we should not ignore.

Regarding diets, mea culpa! I like cheeseburgers and doughnuts in moderation, but I don't guilt-trip anyone for eating oatmeal — even my friend who insists on having it with skim milk and dry toast!

Practice Diary is meant for the pure enjoyment of FPM readers. So take it with a grain of salt — unless, of course, you're hypertensive.


Copyright © 1999 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Sep-Oct 2020

Access the latest issue
of FPM journal

Read the Issue

FPM E-Newsletter

Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights."

Sign Up Now


Maternal Immunization Task Force for Pregnant Women: A Call to Action
The current increase in hesitancy about the safety and efficacy of vaccines has created an environment that calls for physicians’ urgent commitment to discussing the evidence-based benefits of vaccination with pregnant women.

Keys to High-Quality, Low-Cost Care: Empanelment, Attribution, and Risk Stratification
Understand attribution and alignment methodologies in value-based payment arrangements to know which patients are assigned to you. Use empanelment and risk stratification to better understand where to expend your practice's care management and care coordination resources.