Christopher Lazopolous, a recommendation was made that the Royal Adelaide Hospital implement measures to ensure that X-ray films and reports were always made available to Emergency Department practitioners whenever a patient re-presents to the Emergency Department. A similar recommendation can be made in my view in respect of ensuring that clinical notes are also similarly made available in Secondly, there is a question as to the level of expertise that should be brought to bear upon the diagnostic exercise involved in a re-presentation. In the same Inquest of Lazopolous I made a further recommendation that the Royal Adelaide Hospital should consider implementing measures whereby patients re-presenting to the Emergency Department of that hospital are personally examined or reviewed by practitioners of the rank of registrar or above before they are discharged. In the present case the evidence is not entirely clear to me as to the exact involvement of the registrar, Dr Detlev Seifert, during the re-presentation by Mr Farkas on 21 October 2005. It will also be remembered that Mr Farkas was examined, treated and discharged by Dr Tan, an intern. It occurs to me that an inappropriate level of emphasis is placed upon the involvement of the more senior medical practitioner at the time of discharge as opposed to the time of examination. One would have thought that in cases of especially where the possibility of a diagnosis of a serious illness might be at stake, the involvement of the senior practitioner ought to occur sooner than later in the presentation. For instance, it does not seem right that an intern should be embarking upon a plan of treatment without first having consulted a more senior practitioner about that plan. The Orientation Guide to the Emergency Department at the Modbury Hospital contains within it a section concerning supervision of junior practitioners. It sets out a protocol in respect of discharge. Newly appointed CMOs, junior medical staff and casual medical officers are required, pursuant to the protocol, to seek the authorisation of a senior medical officer to discharge patients who have been referred to the department by a general practitioner for review. That was the scenario with Mr Farkas on 21 October 2005. Junior medical staff are also required to discuss with a senior medical officer any patient who has for an unplanned ‘returned I take it that this requirement refers to patients who unexpectedly re-present review’. with the same complaint, like Mr Farkas. It is difficult to know what value can be placed upon mere discussion as opposed to the senior practitioner examining the patient for him or herself. One suspects that it all depends upon the circumstances.
Christopher Lazopolous, a recommendation was made that the Royal Adelaide Hospital implement measures to ensure that X-ray films and reports were always made available to Emergency Department practitioners whenever a patient re-presents to the Emergency Department. A similar recommendation can be made in my view in respect of ensuring that clinical notes are also similarly made available in Secondly, there is a question as to the level of expertise that should be brought to bear upon the diagnostic exercise involved in a re-presentation. In the same Inquest of Lazopolous I made a further recommendation that the Royal Adelaide Hospital should consider implementing measures whereby patients re-presenting to the Emergency Department of that hospital are personally examined or reviewed by practitioners of the rank of registrar or above before they are discharged. In the present case the evidence is not entirely clear to me as to the exact involvement of the registrar, Dr Detlev Seifert, during the re-presentation by Mr Farkas on 21 October 2005. It will also be remembered that Mr Farkas was examined, treated and discharged by Dr Tan, an intern. It occurs to me that an inappropriate level of emphasis is placed upon the involvement of the more senior medical practitioner at the time of discharge as opposed to the time of examination. One would have thought that in cases of especially where the possibility of a diagnosis of a serious illness might be at stake, the involvement of the senior practitioner ought to occur sooner than later in the presentation. For instance, it does not seem right that an intern should be embarking upon a plan of treatment without first having consulted a more senior practitioner about that plan. The Orientation Guide to the Emergency Department at the Modbury Hospital contains within it a section concerning supervision of junior practitioners. It sets out a protocol in respect of discharge. Newly appointed CMOs, junior medical staff and casual medical officers are required, pursuant to the protocol, to seek the authorisation of a senior medical officer to discharge patients who have been referred to the department by a general practitioner for review. That was the scenario with Mr Farkas on 21 October 2005. Junior medical staff are also required to discuss with a senior medical officer any patient who has ‘returned for an unplanned review’. I take it that this requirement refers to patients who unexpectedly re-present with the same complaint, like Mr Farkas. It is difficult to know what value can be placed upon mere discussion as opposed to the senior practitioner examining the patient for him or herself. One suspects that it all depends upon the circumstances.
FARKAS%20Karl%20Derek.docx