A 44 year old woman is discharged from the nearby major medical center after a 48 hour stay. She underwent an uncomplicated left thyroidectomy for suspicious cells. Once home, her throat was sore from anesthesia and it hurt mildly to swallow and to take a deep breath. She tried to contact her primary care doctor over the weekend, thinking she needed a refill of a very old asthma inhaler, but got the covering doctor who told her to go the local emergency room.
The ER doctor heard "post-op" and "short of breath" and ordered a d-dimer test and chest x-ray looking for a pulmonary embolism. The d-dimer was slightly elevated, but this would be expected post-op. Her chest x-ray was clear. The rest of her work up, including complete blood work and an EKG were normal. He told her to go home but by then, 6 hours into her ER visit, she became increasingly anxious as she had become convinced that maybe she really was sick, perhaps with a blood clot. She cried, became a little hysterical and became more short of breath.
She was transferred by ambulance back to the major medical center where the operation had taken place. She was admitted to that hospital by the surgeon who was covering for the surgeon who had operated. This weekend surgeon did not know her case. She was kept overnight and felt better in the morning and was discharged home. That day, Monday, she called her primary care doctor who prescribed the refill for the asthma inhaler she wanted in the first place and felt better.
How much did this work up cost? Was anybody listening?
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