The unbearable rightness of bedside rationing. Physician duties in a climate of cost containment
Ubel, P.A.; Arnold, R.M.
Archives of Internal Medicine 155(17): 1837-1842
1995
ISSN/ISBN: 0003-9926 PMID: 7677549 Document Number: 440891
A local internist is in the process of ordering an intravenous pyelogram for a patient she suspects of having kidney problems, when a medical student shadowing her in clinic interrupts. The student wants to know why the physician is not ordering a low-osmolality contrast agent for the patient, having read that they are less likely to cause serious side effects than high-osmolality contrast agents. The physician realizes that the medical student is correct, but rejects the suggestion, telling the student that "low-osmolality contrast agents are the standard of care for low-risk patients."