1 #periopmedicine is not just testing. It’s a patient-centered H&P. You need to TALK TO A PATIENT, examine them, & reason through pre-op challenges. This is clearly supported by the language & outline of the 2007 ACC/AHA guidelines. It literally starts with “history”
* How do we recognize and articulate that uncertainty?
* How do we stay curious?
* What do I ask next?
* Where do I look next?
* Do I need to order an ECHO/stress test to settle this??
⬅️ “History of coronary disease”
⬅️“history of MI”
⬅️“chest pain” with elevated troponin
What was this originally??
“CAD” got deleted from the EHR and the patient did
NOT get a preop stress test
conversations w patients:
* Stay curious
* Acknowledge uncertainty
* Talk to and examine your patients
* Keep learning and growing from the care you’ve provided and decisions you’ve made for prior patients
Thank you for reading & reasoning!