Original contributionComparison of EPs’ and psychiatrists’ laboratory assessment of psychiatric patients
Section snippets
Methods
A survey was developed to ascertain the testing that was routinely performed or required by EPs and a similar one for the psychiatrists. The two almost identical surveys contained information on the physician demographics, including age range, race, gender, hospital information (including transfers, beds, and volume), tests routinely ordered or required (including laboratories, radiographs, electro cardiogram, electroencephalogram), and estimated cost of testing. All of the Illinois EPs and all
Emergency physicians
The survey was returned by 507 of 1,055 (48.1%) of the EPs and 66 of 117 (56.4%) of the psychiatrists. A total of 37% of EPs responded who were mostly 31 to 40 years old (189 of 507), male (347 of 489), and board-certified (348 of 477) (Table 1). Similar numbers worked in an urban setting (48.1%) and suburban setting (46.9%) that was a teaching hospital (27.6%) with mean operating beds of 159 and mean ED volume of 46,701. Three hundred thirty-five of 505 (66.3%) have a psychiatric unit at
Discussion
Although the study did uphold the hypothesis that the EPs and psychiatrists have a different set of routine tests, the hypothesis was not upheld for required testing. The reason for this discrepancy is uncertain. It is thought that EPs order tests that will ensure that the psychiatric patients will be accepted at a psychiatric facility. The evidence in this study that backs up this contention is the number of EPs who do not order any tests and the number that order fewer tests compared with
Conclusion
EPs tend to order a different set of routine tests but a similar set of required tests for the medical evaluation of the psychiatric patient in the ED. These results indicate that there is concurrence in the testing that should be done on psychiatric patients. Whether the EPs changed their practice pattern to accommodate the psychiatrists or agreed with the need to order the set of tests is unknown.
Acknowledgements
The authors acknowledge the efforts of the Illinois Department of Mental Health Medical Clearance Work Group.
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