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From Martin Herman's response I see that I will have to be more specific in
order to be clear.
 
I will be starting a pediatric private practice on the grounds of an adult
hospital in a large city.  The hospital added an ER department several years
ago, and the doctors there (some ER docs, some internitsts) also treat some
children for minor trauma minor medical complaints.  The hospital does not
have inpatient pediatrics or obstetrics, and does not plan to add them. I
will not be employed by the hospital. However, I have agreed to provide
telephone consultation to the ER docs for pediatric cases, and in cases
where unassigned (to another pediatrician) children need to be admitted to a
nearby hospital (2 miles away) where I have privileges, I will facilitate
the transfer and admission.
 
There are several hospitals within a 5-or-so mile radius that have pediatric
inpatient services, as well as even a full pediatric ER or two, and a
children's hosptial.
 
The hospital wants to advertise that now they have "pediatrics" at the
hospital, but I asked them to not say it that way, because it implies that
they added pediatrics inpatient services.  I asked them to say "private
practice pediatric office" or "office-based pediatrics."
 
The hospital decided that their ER docs were tending to give the message "we
don't see children" because they were not comfortable doing so.  Therefore,
they designated one treatment room as a "pediatric room" and decorated it to
make children feel more at home. Now management wants to advertise to the
public that there is pediatrics at the hospital, and that their ER has
pediatric servcies.
 
The problem I see if they do so, is that some parents, and some
professionals, will assume that there is inpatient-level pediatrics there
now, and expect those kind of resources.  Suppose "definitive treatment" is
delayed while a child shows up there who needs to be transported for
admission to a nearby hospital where they maybe should have gone in the
first place?  (we are not talking about this hospital being the only choice
available in a 20 mile radius, for example.)  Since I am on call for at
least telephone consultation to the ER, i fear being medioclegally
responsible for claims of misrepresentation of services, etc.  I realize
that even without such advertising, an occasional seriously ill child will
show up and need to be transported.  However, I want to avoid publicity
which would increase such cases. I also want to avoid having parents and
other doctors feeling that the services provided are not what are implied by
the advertising.
 
Am I just being paranoid?
 
For help send e-mail to: [log in to unmask]
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html