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Doc ApprovED: A Consult Without the Insults

Mohseni, Alex, MD

doi: 10.1097/01.EEM.0000544443.67817.21
Doc ApprovED

Dr. Mohseniis an emergency physician in the Washington, D.C., metropolitan area, and has his own blog, http://CreativeHealthLabs.com. Follow him on Twitter @amohseni, and read his past EMN columns athttp://bit.ly/EMN-DocAPProvED.

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‘Jack of all trades, master of none” is a common refrain in emergency medicine. It is simply impossible for EPs to have the same depth of knowledge as our specialist colleagues, and a hard part of our job is the joy some specialists take in belittling EPs when called. Some have a particular talent in denigrating us.

One of the most painful experiences is to see one of your new young colleagues berated on the phone because he called a specialist at 2 a.m. and is having difficulty describing the problem. It gets worse when we try to have an informed discussion about management. It's a horrible experience and an awful way to have your first contact with a specialist whose advice you will need for the rest of your career.

Help is here for orthopedic consults, at least. The OrthoFlow app is $5 on iOS (not available on Android, as of press time), and Ortho Traumapedia, which has many of the same features, is $10 on iOS or Android. OrthoFlow is designed more for orthopedic residents, but seeing the information from a surgeon's perspective is awesome and almost feels like cheating. The app has high-yield information about each fracture type and location, including anatomy, associated injuries, types of imaging, classification, management, surgical approaches, complications, and references. The app also guides you through an assessment workflow to determine management recommendations.

OrthoFlow has additional valuable sections, including information on ortho-specific concerns such as avascular necrosis and compartment syndrome. But its best section is the one on standard fracture terminology, which explains exactly how to describe any fracture and injury in a manner that would make your orthopedist's heart melt.

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