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I can appreciate your position but we have several patients that have
filters in place and they are given lovenox and coumadin at home Many
have chronic with acute thrombus formations. These patients are not
considered a risk at home-and often are Cancer patient and do better in
the home environment rather than in the hospital. 
Lisa

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Pamela
Wickkiser
Sent: Wednesday, April 26, 2006 5:06 PM
To: [log in to unmask]
Subject: Re: DVT patients

I too had such an incident. My patient had an extensive DVT that had the

ability to become a PE at any moment. Their family physician told me to 
send the patient home and come to the office tomorrow. I tried to 
emphasize the serious nature of the DVT, but the physician would not 
change his treatment plan. At this point I called our Medical Director
to 
intervene on the patients behalf. There was some hesitation on his part,

but he ultimately called the family physician and explained our concern.

Finally, the referring physician admitted the patient. 

With all the liability concern why would a physician take such a casual 
position on a diagnosed acute DVT is beyond me.

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