Several years ago, a young woman came to my emergency department with a complaint of left breast pain. She was three weeks postpartum and breastfeeding her infant. In triage, she was found to have a low-grade fever and a fast heart rate. It was, as usual, a busy evening, and about 30 minutes later, I was able to pull myself over to the patient’s room to evaluate her. As I walked in, I noticed that the patient already had an IV placed and was receiving intravenous fluids and, to my horror, intravenous Zosyn (about $330 per dose). Zosyn is a powerful antibiotic used for patients suffering from severe bacterial illness (sepsis) in the hospital. My shock must have registered with the patient as she glanced up at me from her cell phone with a look of mild bemusement. 

“Is everything OK, doc?”

“Yes,” I replied while recovering from my initial disbelief at the level of care she had already received prior to any physician evaluation. 

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