An Ohio nephrologist was arrested on a misdemeanor assault charge. He had pushed a cardiologist during an argument over the treatment of a hospitalized patient.

 

According to an article on the website of an area television station:

The hospital issued the obligatory statement after any physician misbehavior pointing out that Barton was not an employee, no patient was harmed, and distancing itself from anything that happened.

 

What could they have been arguing about? My best guess is the nephrologist wanted to give the patient IV fluids to protect the kidneys while the cardiologist wanted to restrict fluid because of a heart problem.

 

Or the cardiologist may have ordered a potentially nephrotoxic drug which Barton felt was contraindicated.

   

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The electronic medical record may have played a part in the dispute. Most EMR progress notes are long and filled with material copied and pasted from the previous day’s progress note. Information such as lab results and x-ray reports easily found in other portions of the record are often inserted. Few physicians write what they are thinking or why they ordered a drug. Many notes do not contain a coherent assessment or plan.

 

In many hospitals, consultants can only make recommendations unless asked to manage part of a patient’s care by the admitting physician.

 

The article said the hospital’s chief medical officer had reported the incident to police. Was that really necessary? This skirmish could have been prevented if the CMO or the chair of medicine had been involved as a mediator.

 

Lost in all of this is the poor patient. I wonder how he/she fared. Did a neutral party take over the patient’s care?

 

Skeptical Scalpel is a retired surgeon and was a surgical department chair and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last 9 years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog has had more than 3,700,000 page views, and he has over 21,000 followers on Twitter.