Aggravated DocSurg: To CT or Not to CT? Another Salvo
Common things being common, anyone who has spent a little time perusing medical blogs has read a few posts about the value, or lack thereof, of CT scans in the evaluation of suspected acute appendicitis. I’ll outline my opinions below (Opinions? Moi?), but there has been another salvo fired in this skirmish, this time aimed against the “CT everyone” crowd.
Your ED’s mileage may vary, and the “CT everyone” crowd is usually the surgeons. The ED Docs would love to avoid ordering them.
I’m a CT tech at a level II ER. The ER docs had no CT coverage on midnights, but had CT on call for r/o bleed or r/o appy. Do you ER docs see where this is going…I made an extra $23,000 in call in pay last year-every abcess,diarrhea, LUQ pain, diverticulitis,& drunk that fell off a ladder trying to change a lightbulb at 3:00a became an appy. Hell, I’ve been called in for appy &
the pt tells me they don’t have an appendix. Administration finally realized you guys were gonna get your CT’s and after paying out enough O/C pay to fund 2 full time midnight techs–they did just that!
Now we just radiate everyone who should get an ultasound first, since US is on call for torsion and ectopics only..ha,ha-ya gotta love it. (See earlier story-dr’s daughter get expensive CT when she needed US)
Why in the world would a Level II not have 24/7 CT coverage already? Oh, because Trauma and illness only happen during business hours, I get it. I’m glad they’ve caught up with the rest of the world.
As far as your ‘see earlier story… : here’s what I/we had to say