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Thanks for your comments. As I was on the other end of the phone, I have no idea what the parents were told, or not by the ED physician. I tried to share the information available with the physician, and I hope he shared it appropriately, but I have no idea whether my ten minute conversation was translated into: "Dr. Ackerman is refusing to accept your child" or "Dr. Ackerman has advised us that this problem is self-limited, and given how much we have already done here, will not need to do any additional testing, and will likely be sending your child home in a few hours."
I agree that the parents need to be part of the conversation, and in fact, after I got off the phone, almost called back to offer to speak with them directly on the phone. This is one area where telemedicine can help us, and once we have a reliable web-based telemedicine product that would have allowed me to converse with them "face-to-face" from my home to explain the evidence behind my recommendation. I suppose I could have just used skype--but most emergency rooms would not have a web cam available in the middle of the night.

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