Different commentators have used the term "voltage drop" to refer to various things related to medical care. One use is to refer to the efficacy-effectiveness gap, i.e the difference in outcomes from clinical trials to treatment in the real world in which subjects are not carefully selected and care is not closely monitored to conform with the clinical trial protocol.
Here I use the term to refer to the drop off in communicative content and efficiency and content validation when a medical assistant is the interface between the patient and the physician. The following is based on a real scenario .
On day zero a patient met with a gastroenterologist with a clinical picture which warranted a colonoscopy and an upper GI tract endoscopy ( which in current jargon is called a bidirectional endoscopy ) Because the patient had a pacemaker (PM) the patient was informed that his EP cardiologist would have to give clearance . before the procedure could be scheduled Eight days later the GI docs (MA)sent a message to the EP doc office whose MA apparently did not reply until day 13 . The patient then was informed that for some undisclosed reason the clearance was unsatisfactory and it was not until day 20 that a second clearance was sent to GI and then the procedure was scheduled for 2 weeks later.
It should be noted that the two physicians both work for clinical practice groups which are part of the same large "not for profit hospital" system and are actually located on adjacent floors of the same building.
So why did it take three weeks to obtain a routine pre endoscopy cardiac clearance. Why do I point blame at the MAs rather than the administrative burden that grew up in a large medical system. Obviously both are at fault but I submit the MAs replacing RNS in physician offices to save money (big salary difference) is replacing someone with very little medical knowledge and maybe even less sense of responsibility to the patients.
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