Admission

On the very last day of CSC, we had a lunch time service meeting on the coming admission ward system. (Of course our retiring professor was not there - he had very little to do with service.)

Some of my friends would know I have a completely schizophrenic view on this matter. On one hand I have long for triaging acute medical admissions according to the sub-specialty. However I am somewhat uneasy with the proposed "protocol-driven" management. (There are certainly political considerations in my amygdala, which I shall not elaborate.)

Yes, we can cover 80% of our acute admissions by six or seven diagnosis - and we could design protocol for each and every one of them. Nonetheless, not all exacerbation of chronic bronchitis (or heart failure or stroke) are the same.

And my anxiety goes further up when I come to realize that those protocols aim to discharge the patients in four days. In other words, they got to be highly intensive and focused (i.e. narrow-minded in sugar coating) - and would deliberately turn away from the possibility of difference between individuals.

It seems trying to draw a rose by a ruler.

(Oh, yes, ruler. What an appropriate term.)

The creatures on Pluto have probably consumed too many eggs in mechanical circle.

PS. As KM points out, an important aspect of medical practice is to pick up the case of theophylline overdose amongst the 100 emphysema patients that you see - it would never happen if the only thing we do is to follow a protocol.