To: all staff physicians at Community Hospital

From: Neurology staff

RE:  Thrombolytics for stroke

In our amazing era of evidence-based medical innovation, studies have suggested that thrombolytic agents have a beneficial role in the management of ischemic CVA.  As you all know, it appears that lives may be saved, and individuals may enjoy a return to baseline neurologic function, if thrombolytics such as Tissue Plasminogen Activator are adminstered within three hours of symptom onset, and according to specific, pre-set guidelines.

The ‘Stroke Team’ concept requires the expertise of emergency physicians, neurologists and radiologists in order to give stroke patients the greatest benefit and highest likelihood of a return to their normal lives.

However, the neurology department at Community Hospital feels that this is simply too time-consuming and risky, and hereby withdraws from involvement in this much sought-after, much studied and much touted therapy, which now graces American billboards and public service announcements, causing patients to specifically ask for ‘clot-busters.’

While it may seem confusing, please do not take this action as evidence of disinterest.  Other physicians with less expertise will still be available to administer thrombolytics to appropriate patients with ischemic CVA.

We hope you’ll pardon this inconvenience.  Please continue to consider us for the management of assorted neurologic conditions that are less urgent, less time-consuming and less perilous.

The neurology staff of Community Hospital.

(PS  As always a disclaimer.  This feature parodies the accumulated experiences of assorted physicians in the US.)

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