I am walking out of the local drug store about to get into my car when a womans voice behind me says, "excuse me sir, excuse me, are you a doctor?" 

 

WTF? "Uh, no, medical student." Its been a long enough day and I have a headache. I was out of ibuprofen at home so stopped after work to restock. Still in my scrubs I might as well have had a target painted on me.

 

She continues "Well, my doctors office is closed and my son broke his toe and I was wondering if you think we should go to the Emergency Room? A couple of friends of mine have told me that all they would do, aside from an X-ray, is to ice it, tape it and prescribe Advil. What do you think?"

 

The inner monologue is saying, are you fucking kidding me? But I am a healer at heart so I say "If it were me I'd X-ray it, there is really no way to know how bad the break is without it, but it is your call. If it is minor yes, your friends are right, the treatment is basically supportive."

 

She thinks a moment and says "Well he is supposed to go out with his friends tonight, Friday night out and all, and so is begging me to wait until tomorrow to go. It happened yesterday and I am just wondering if I am really going to wish I had gone in sooner."

 

"Hmmm. Well I can't really answer that question for you. The emergency dept. can be a pretty busy place and you will likely wait for several hours on a friday evening to be seen. Since it happened yesterday I can assume it is not an emergency, so if he can wait until the morning your wait time will likely be significantly less." As this comes out of my mouth I can't help but wonder if I am making a mistake by talking to her at all. The advice is good, but is it the best? I am checking off the principles of Autonomy, Justice, Benevolence (do good) and Non-Malificence (do no harm) in my head.  I can't simply fill out paperwork for her and I wasn't about to go asking where he was and look at the toe, so I followed up with, "If it were me, I'd want to know what the X-ray looks like, but you can take that info and do what you will with it, I can't say what the best course of action is."

 

She gave thanks and I ducked outta there understanding for the first time where the phrase "Curbside Consult" came from

 

The interaction leaves me frustrated. Not at the consult, but at a system that has become so bogged down in the legal world. I couldn't just give her my opinion without first checking it against liability. I basically told her what I would have any other time, but I had to chose my words carefully making sure to say things like "I can't tell you what you should do, but if it were me..."