Ubel P A, Arnold R M
Veterans Affairs Medical Center, Philadelphia, Pa.
Arch Intern Med. 1995 Sep 25;155(17):1837-42.
A local internist is in the process of ordering an intravenous pyelogram for a patient she suspects of having kidney problems, when a medical student shadowing her in clinic interrupts. The student wants to know why the physician is not ordering a low-osmolality contrast agent for the patient, having read that they are less likely to cause serious side effects than high-osmolality contrast agents. The physician realizes that the medical student is correct, but rejects the suggestion, telling the student that "low-osmolality contrast agents are the standard of care for low-risk patients."
一位当地的内科医生正在为一名她怀疑有肾脏问题的患者安排静脉肾盂造影检查，这时一名在诊所跟随她实习的医科学生打断了她。该学生想知道为什么医生没有为患者开低渗性造影剂，因为他读到过低渗性造影剂比高渗性造影剂引起严重副作用的可能性更小。医生意识到医科学生是正确的，但拒绝了这个建议，告诉学生“低渗性造影剂是低风险患者的标准治疗方法”。
