Real-Life Decision Making
An echocardiographer is responsible for uncovering abnormalities and diseases of the heart. Technologist Margaret Corbett says she performs an ultrasound on a patient's heart and then interprets the results of the echo in a written report. The doctor then reads the report.
The echocardiographer has enough medical knowledge to know whether the patient's heart is in good shape or bad. No matter what the echocardiographer sees, however, it is always the doctor who reports the final findings to the patient. The doctor has had more training and experience and knows his patient's history better.
The clinic you work for often schedules a few ultrasounds on Saturday. This Saturday you must perform three scans. It is near the end of the day and you are anxiously awaiting your last patient so that you can go home.
Mrs. Smith arrives 30 minutes late. She is a wreck. She comes into your office pale and sweaty. You are afraid it might be her heart. You look at her record. There is no indication from her last physical that she has any heart abnormalities. Her father had coronary heart disease and her mother died from heart disease as well. They were right around the age Mrs. Smith is now. You guess correctly that she is here just as a precaution.
"I've always taken care of myself," says Mrs. Smith. "But sometimes, you just can't escape the genes."
As you rub the transducer gel on her heart, she continues to talk. "I've never had these, but Dr. Johnson says it doesn't hurt. I know I'm talking too much, but I'm so nervous."
Mrs. Smith continues to rattle on and apologizes for being late. "I'm sorry about missing the appointment. I mean not being on time. I just couldn't drive, not as nervous as I am. I had to call my son to come get me. I'm so sorry," she says again.
"That's OK," you say. "I was just catching up on some paperwork anyway."
"Where is the doctor?" she asks.
"Oh, there isn't a doctor in on Saturday. Dr. Johnson told me you called him late Thursday and sounded concerned, so he slipped you in today. But he's not here."
Mrs. Smith is now even more nervous. "How will I know if I'm going to live?"
You smile and try to reassure her, but all through the test she is fidgeting. What you see on the screen is even better news, a perfectly healthy heart. All looks good.
Mrs. Smith looks deathly sad and asks you, "Can't you tell me anything?"
What do you do?