ER Doc Faces Complex Decisions
Patients could be admitted or sent home... but which?

HARRISBURG, PA--Dr. Jerry Baylor's been making decisions that affect people's lives since seven this morning, and his day isn't over yet. It's only 4 PM, and he's got three hours left to go.

But Baylor, an emergency physician at Harrisburg's Mt. Holyoke Hospital, isn't thinking about going home. He's preoccupied with the tough choices he's facing for the six patients currently under his care.

E.R. Decision-Making Guide

"In Bed 3," he says, "we've got a woman with a cough and a fever. If her X-Ray comes back positive for pneumonia, I'm admitting her. Otherwise, she might be able to go home. We'll see how she does."

"Then, in Bed 8, there's this guy with some pain in his leg. If the ultrasound shows a DVT, he may get admitted. Otherwise, I'll probably send him home."

And on it goes. Baylor, who prefers to be called an "emergentologist," says he's become accustomed to the challenging dilemmas he encounters every day.

"At first, it was a little daunting," he says. "The first time I had to decide whether a patient should be admitted or not, I almost cried. It was that stressful."

"But after a while, I began to realize that, for the patients that were sick enough to be admitted, most of the real work would be done by the doctors who actually did the admitting - the ones who would actually be taking care of the patient and making them better."

"Also," he adds, "it helps that I don't need to decide which lab tests to order - we just get a full panel for everyone, including cardiac enzymes, troponin levels, thyroid studies, and cholesterol, no matter what they present with."

He says the decision-making skills he's been honing at work has helped him in other areas of his life too.

"When my daughter has a cold, for instance, I instantly fall back on my medical training to make the decision: go to school, or stay home? I can make that determination in about twenty minutes now... ten, if I can get a stat chest film."

But there's one choice Baylor never has any difficulty making.

"When signout's over at 7:15 PM, I'm faced with either staying a bit and helping out with the patients I was seeing, or heading out the door ASAP," he explains.

He pauses to laugh. "And that, my friend, is the easiest decision of all."