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MEdIC Series: The Case of the Orphaned Patient – Expert Review and Curated Community Commentary


Our seventh case of season 5, The Case of the Orphaned Patient, presented the scenario of a junior orthopedic surgery resident rotating in the ED and receiving significant pushback when trying to transfer the care of a clinically deteriorating patient to a more appropriate service. The outcome of this pushback was a patient without a service feeling primarily responsible for further care, leaving the patient “orphaned” in the ED. If you haven’t had a chance yet, we urge you to check out the case and share your thoughts on this important topic!

The MEdIC team (Drs. Tamara McColl, Teresa Chan, Sarah Luckett-Gatopoulos, Eve Purdy, John Eicken, Alkarim Velji, and Brent Thoma) hosted an online discussion around the case over the last 2 weeks with insights from the ALiEM community. We are proud to present to you the curated commentary and our expert opinions. Than you to all participants for contributing to the very rich discussions surrounding this case!

This follow-up post includes:

  • Responses from our solicited experts:
    • Dr. Aikta Verma (@aiktaverma) completed both her FRCPC Emergency Medicine residency training and a Masters of Health Sciences in Health Administration at the University of Toronto. She works as an emergency physician and holds the position of Director of Clinical Operations at Sunnybrook Hospital. She is an Assistant Professor as well as the Assistant Program Director and Competence Committee Chair for the FRCPC Emergency Medicine residency training program at the University of Toronto.
    • Dr. Colm McCarthy (@colmjmccarthy) is a PGY-4 orthopedic surgery resident at McMaster University. He is completing his Masters in Health Science Education at McMaster while in residency. He has an interest in patient, medical student, and resident teaching as well as lower extremity reconstruction and trauma. He is passionate about patient and physician advocacy and strives to make learning a fun, humorous, and memorable experience.
  • A summary of insights from the ALiEM community derived from the Twitter and blog discussions.
  • Freely downloadable PDF versions of the case and expert responses for use in continuing medical education activities.
Expert Response 1: Who's Patient Am I? (Dr. Aikta Verma)
Expert Response 2: Orphaned Patients: A Complex Administrative Dilemma (Dr. Colm McCarthy)
Curated from the Community (Dr. John Eicken)

Case and Responses for Download

Click here (or on the picture below) to download the case and responses as a PDF (169 kb).

Tamara McColl, MD FRCPC

Tamara McColl, MD FRCPC

Associate Editor, ALiEM MEdIC Series
Emergency Physician, St. Boniface Hospital, WRHA
Academic Lead, Educational Scholarship
Department of Emergency Medicine
University of Manitoba