The main role of emergency medicine specialists is to decide whether to admit a patient to the hospital for treatment, observation or further investigation. However, a critical function of the ER doctor is to interpret early test results to decide whether the patient’s condition is life-threatening or not. In this regard, ER physicians must be able to accurately interpret a number of basic screening tests, such as x-rays and blood work. However, a sobering study in the Journal of Digital Imaging shows that often the ER doctor’s interpretation of radiographs is wrong.
ER admissions routinely peak on evenings and weekends when board-certified radiologists may not be available. Many times, the ER doctor will provide a provisional interpretation of imaging studies while awaiting the arrival of the radiologist. The radiologist may come in the following morning, read the film and dictate a report hours after the patient’s treatment has started or after the patient has been sent home.
Hospitals are required to have all films, including CT scans (also called CAT scans), radiographs, KUBs and MRIs, read by a radiologist. This is for good reason: films can be difficult to interpret. When the radiologist reads a film, however, they may not know what the ER doctor’s provisional diagnosis was. The Journal of Digital Imaging article recommends that radiologists be informed of the ER physician’s provisional diagnosis and to report any discrepancy. This process is only helpful, of course, if the patient hasn’t died or suffered some other permanent injury in the meantime.
In emergency medicine, time matters. If physicians base treatment decisions on misread imaging studies, bad things can happen. If a radiologist comes along later and reads the film correctly, but such information is not communicated to the patient’s direct care providers or the patient, and harm results, a claim for medical negligence may exist under Ohio law. Medical malpractice is costly to all of us, so efforts should be made correct errors as soon as possible.
