Post by Paul BearerI'm watching the first scenes with Dr. Rory Gilmore, shouldn't she
have a doctor supervising her now that she is an intern?
.
All residents are required to have direct supervision from an attending
physician. It'a not only a requirement for residency, it is required to
receive payment for the services. No insurance companies, Medicaire or
Medicaid will reimburse for care provided by residents unless there is an
attending present in the room while that care is being provided. ER has
always pretended that the interns and residents are more autonomous than
they would be in real life. The show has also shown the ER docs to have far
more experience with procedures and often doing things that, in real life,
would only be done by a specialist. And the residents arguing with
attendings thing never happens, either. Attendings are the boss. Period.
If a resident disagrees with an attending, he/she finds another attending to
intervene and usually, he/she will discover that the first attending was
right anyway.
For example, on the last eppy, the attending called for a fetal monitor to
be placed on the pregnant patient. Firstly, fetal monitors ain't cheap, the
one ER had runs about $30,000. Secondly, putting a patient on the monitor
so that it is able to trace the fetal heart rate and contractions is an
acquired skill and an ER nurse who maybe puts a pregnant lady on a monitor
twice a year wouldn't be able to do it as quickly as we saw on Thurs. She'd
have been moving the transducer all over the lady's belly trying to find the
heart beat on the first baby and then she'd have to find the other twin,
too. Finally, interpreting a fetal heart tracing requires a lot of study
and training and looking at hundreds, if not thousands, of strips. It's not
something for an ER doc to do on the fly. The ER doc was no more qualified
to diagnose fetal distress than I would be to diagnose a heart attack by
looking at an EKG.
Sharon