Lung check in hospital
July 25, 2022 11:04 AM Subscribe
I’m in the hospital for some thing that is in no way related to my lungs. Why do doctors always check my lungs when they make rounds? I’m just curious.
If you have to lie down a lot, fluid can collect in your lungs and you can develop pneumonia. They’re trying to make sure that doesn’t happen.
posted by corey flood at 11:27 AM on July 25, 2022 [18 favorites]
posted by corey flood at 11:27 AM on July 25, 2022 [18 favorites]
I think it's just part of the standard look under the hood, they way they always check kids' ears. But especially now, there's, um, this virus that's been going around, and it primarily affects the lungs and has some long-term effects we still don't know about. So I mean, yeah, I'd pretty much expect a lung check now.
posted by kevinbelt at 11:29 AM on July 25, 2022 [4 favorites]
posted by kevinbelt at 11:29 AM on July 25, 2022 [4 favorites]
Also, it is cheap, easy and fast to check so the cost for checking is very low.
posted by mmascolino at 11:39 AM on July 25, 2022 [2 favorites]
posted by mmascolino at 11:39 AM on July 25, 2022 [2 favorites]
If you do a "complete" exam of multiple systems you will bill and get paid more than if you assess only one system.
posted by FungusCassetteBicker at 11:41 AM on July 25, 2022
posted by FungusCassetteBicker at 11:41 AM on July 25, 2022
Pneumonia can come on terrifyingly fast in the hospital, from being sedentary and semi-prone, and you may not feel it right away because you're not exerting yourself much and may be experiencing anxiety that produces chest tension and masks the early sensations as well. The crackle of pneumonia is a reliable early tell.
posted by Lyn Never at 11:47 AM on July 25, 2022 [27 favorites]
posted by Lyn Never at 11:47 AM on July 25, 2022 [27 favorites]
Impaired heart and kidney function can also present as a crackle, even though you might not feel any symptoms except maybe feeling a little tired or out of breath.
posted by mochapickle at 11:54 AM on July 25, 2022 [3 favorites]
posted by mochapickle at 11:54 AM on July 25, 2022 [3 favorites]
If you do a "complete" exam of multiple systems you will bill and get paid more than if you assess only one system.
And in the US, insurance would reject that bill if they did not agree it was necessary. Doctors doing rounds in hospitals are often trying to get through as many patients as possible. The idea they would perform this check multiple times per day to pad their bottom line is a pretty cynical view. As said above, pneumonia is a big risk for bed bound patients.
posted by soelo at 12:14 PM on July 25, 2022 [12 favorites]
And in the US, insurance would reject that bill if they did not agree it was necessary. Doctors doing rounds in hospitals are often trying to get through as many patients as possible. The idea they would perform this check multiple times per day to pad their bottom line is a pretty cynical view. As said above, pneumonia is a big risk for bed bound patients.
posted by soelo at 12:14 PM on July 25, 2022 [12 favorites]
(IAAD, NYD) Many reasonable reasons to auscultate [listen to] the lungs given above, but there are still lots of hospitalized patients who don't have a strictly "medical" reason to warrant daily pulmonary exam. This is a topic of perpetual debate among physicians, so much so that it was the subject of a point-counterpoint in the Journal of Hospital Medicine last year. If you're not up for reading/don't have access to academic journal articles, you might find this Twitter thread that prompted the essays to be more accessible.
tl;dr: some of it is routine, some of it is practice (that doesn't harm the patient) for trainees, some of it is because doctors think patients expect doctors to do this and feel slighted if we don't, some of it probably is because of billing expectations, and often it is medically necessary.
posted by telegraph at 2:14 PM on July 25, 2022 [11 favorites]
tl;dr: some of it is routine, some of it is practice (that doesn't harm the patient) for trainees, some of it is because doctors think patients expect doctors to do this and feel slighted if we don't, some of it probably is because of billing expectations, and often it is medically necessary.
posted by telegraph at 2:14 PM on July 25, 2022 [11 favorites]
Definitely checking to make sure you don't get pneumonia. Hospital Acquired Pneumonia is a thing, it comes on quickly and is often worse than the type you can get when not in hospital. It's a big risk if you are laying still a lot, and your immune system and body are already under stress from another condition as chances are you won't be breathing as deeply as usual so won't notice early signs. Pneumonia and related conditions are in the top 10 leading cause of death in the US so is a risk to be taken seriously. Think of it as better safe than sorry. Everyone here going on about how it's a billing situation, I have been in Australian & UK hospitals and they still do it there.
posted by wwax at 2:52 PM on July 25, 2022 [2 favorites]
posted by wwax at 2:52 PM on July 25, 2022 [2 favorites]
Part of a fluid balance assessment, which may be relevant if you have been admitted with a heart, kidney, liver issue or are receiving IV fluids.
posted by chiquitita at 12:22 AM on July 26, 2022
posted by chiquitita at 12:22 AM on July 26, 2022
In addition to the above, auscultation (as it is known) also allows the physician to listen to the heart. A two-for.
posted by yclipse at 4:22 AM on July 26, 2022 [1 favorite]
posted by yclipse at 4:22 AM on July 26, 2022 [1 favorite]
I am a gynecologist and my husband is a PCP. We both agree that heart and lung exams are done to make patients feel like they have been examined. I have been known to close my eyes to rest for a few moments while listening to lungs on early morning gyn rounds.
posted by i_am_a_fiesta at 6:36 PM on July 26, 2022 [3 favorites]
posted by i_am_a_fiesta at 6:36 PM on July 26, 2022 [3 favorites]
This thread is closed to new comments.
posted by SPrintF at 11:19 AM on July 25, 2022 [3 favorites]