From Receiving End to Now The Sending End

MO (Medical officer) A is referring a case to MO B.

MO A: "Hi Dr. X, I have a case to refer..."

MO B: "Ok. (sounds really unhappy like MO A owes him something)"

MO A: "I have this 60 year-old lady here who was admitted for uncontrolled diabetes, her condition actually improving with insulin Rx and hydration. However, today she's noted to have spiking temperature, increasingly tachypneic and HR goes up to 130bpm, SPO2 92% under room air. ECG showed sinus tachycardia with some RV strain pattern."

MO B: "Ok so? You want to refer for?"

MO A: "The family member just came and gave a history that she was actually not ambulating for the past 1 week. With this history and correlating with the acute respiratory symptoms I am worried of acute pulmonary embolism."

MO B: "It can also be just a pneumonia right? You can't manage there is it?"

MO A: "(Try to keep his patience) Yes it still can be. But, as I said, PE needs to be excluded. I'm referring for a CTPA."

MO B: "Hmm.....(reluctantly) Okla, you send over the patient. Are you going to intubate her?"

MO A: "I think she doesn't need intubation at the moment, looking at her respiratory rate, and maintaining good SPO2 with oxygen."

MO B: "Ya..you all district will always say patient is stable, not tachypneic, then come here will become the other way round. It's ok if you don't intubate, but if anything happens, you'll be responsible ok. Send over now la." (hung up the phone)

Left a frustrated MO A.

I guess most of the district MOs had similar experience. The thing is, I used to be kind of like MO B (but not that bad of corz hehe) who's at the receiving end, but now switched to the position of MO A. I think the feeling of being untrusted and the unfriendliness from the receiving site is rather frustrating.

Hence, when I go back, I'll now know how to talk to district MOs when they refer cases.

First of all, ask them,
"How can I help you?"

After they asked about the cases, ask them, "I think you probably won't feel comfortable managing such cases there. Would you like to send it over?"

Lastly, ask again, "Is there anything else I can help you?"

Ha. Guaranteed the district MO will be happy for a day after the call. The key word here is "help". Yes, when they call, it means that they need HELP! ;)