Credentialing & Privileging

Peer Review Best Practices: Case Studies and Lessons Learned

Credentialing and Peer Review Legal Insider, October 1, 2009

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Clinical scenario #1: Why are you here?
A 46-year-old male presents to the emergency department (ED) with severe pain from a dental abscess that he has had for one week. He is married with four children and worked as a machinist for 20 years before being laid off due to the failing industry. He is completing his training to become a computer programmer and is using all his financial resources to put his two oldest children through college. He put off seeking treatment for his dental issues for almost one year because he was waiting for his new dental insurance to take effect in three months from now.
He presents to the ED at 10 p.m., with the reasoning that he can complete his computer studies during the day and his wife can be home with the family after work. The emergency physician does a cursory exam and asks the patient, “Why are you here? Don’t you have a primary care physician or, better yet, a dentist to see? Why did you allow your tooth to get to this point? Don’t you care about your health?”

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