Will efficiency trump education?

In this article, Dr Kieran Walsh uses a clinical scenario to discuss the pressure trainee doctors face when treating a patient with complex medical conditions within hospital waiting times.

Kieran discusses the appropriate balance needed to provide patient-centred care, education from seniors and how BMJ Best Practice can help in situations where every second counts.


You are working in an emergency department. You see an 85-year-old man who has fallen at home. He is confused but not in any pain. He has a mild fever, crackles at his left lung base, and slight suprapubic tenderness. He has a history of hypertension, type 2 diabetes, and congestive cardiac failure. He says he is on a number of medications, but is not sure of their names. His daughter is coming to talk to you and she should be in the department in about 30 minutes. You think that you will learn a lot from her and also from your senior—when you discuss this man’s problems with them.

But there is another problem. You are under pressure to refer the patient to the medical team as soon as possible as he is about to breach the hospital waiting time. What should you do? 

Read more