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Patients with suspected acute coronary syndrome (ACS) are frequently admitted from the emergency department (ED) for both medical and medicolegal reasons. To better quantify the proportion of these patients admitted solely due to medicolegal risk aversion, researchers at an academic tertiary care ED in New York City presented physicians with an anonymous survey just after they had decided to admit a patient with suspected ACS. The survey collected demographic data and asked if the patient would have been admitted if there had been either zero medicolegal risk or a 1% to 2% acceptable miss rate.
Over the 3-month study period, physicians completed surveys for a convenience sample of 259 of 576 patients admitted with suspected ACS from the ED. …