Two doctors review a child's medical chart, symbolizing the importance of second opinions in pediatric emergency care.

Second Opinion Savings: How Doctors' Disagreements Can Improve Your Child's ER Care

Reese Marlowe in Health & Wellness December 2025 • 4 min read.

"Unlock better emergency room visits for your kids by understanding the value of medical second opinions and collaborative trainee integration."

In today's fast-paced medical environment, getting the best care for your children often means being proactive and informed. One area where this is especially crucial is emergency room (ER) visits. We trust that the doctors and nurses treating our kids are providing top-notch care, but what happens when medical professionals disagree? A recent study sheds light on the surprising benefits of these disagreements, particularly in pediatric ER settings.

Emergency medicine thrives on feedback. Experts emphasize that receiving high-quality feedback is essential for doctors. This is critical not just for seasoned physicians but also for doctors in training. Modern feedback systems have significantly improved patient care and enhanced the educational experiences of medical professionals. One such area of improvement is in how emergency departments review revisits—when a patient returns to the ER within a short period for the same issue.

Reviewing these revisits is a standard practice for ensuring quality and providing important feedback. By analyzing why patients return, hospitals can identify gaps in care and implement changes to prevent future occurrences. Traditionally, these reviews are conducted by senior physicians. However, a groundbreaking study highlights the importance of including trainees in this process, revealing that differences in opinion between senior doctors and trainees can lead to significant improvements in care.

The Discordance Advantage: Why Disagreements Matter

Two doctors review a child's medical chart, symbolizing the importance of second opinions in pediatric emergency care.

The study, published in the Emergency Medicine Journal, investigated the perceived root causes of 72-hour revisits to a pediatric ER. Researchers aimed to compare the perspectives of attending physicians (senior doctors) and trainees (residents and fellows) to see if they agreed on why patients were returning. The findings were eye-opening: senior physicians and trainees often disagreed about whether a potential medical deficiency was the reason for the revisit. This discordance, while seemingly problematic, actually presents a valuable opportunity for improvement.

Researchers at a large urban academic pediatric ED conducted a questionnaire-based study where both attending physicians and trainees independently assessed revisit cases. They focused on identifying whether the root cause was a 'potential medical deficiency' or something else. The study involved 218 paired analyses of patient revisits and revealed:

Attendings identified potential medical deficiencies in 13% of revisits, while trainees identified them in only 9%.
There was a 17% discordance rate between attendings and trainees in identifying the root cause.
For revisits that required hospital admission, the discordance rate jumped to 25%.

These disagreements highlight that trainees often bring a unique perspective. When trainees and senior physicians review cases together, they foster constructive dialogue, uncover hidden insights, and ultimately enhance patient care. The study supports involving trainees in revisit QA systems and reuniting attending-trainee pairs around revisit cases as a novel educational opportunity.

Empowering Parents: How to Advocate for Your Child

The study's findings empower parents to take a more active role in their children’s healthcare. By understanding that disagreements among medical professionals can be a catalyst for better care, parents can confidently seek second opinions or ask for detailed explanations of treatment plans. Encouraging open communication between doctors and trainees, asking questions about potential discrepancies, and ensuring a collaborative approach can lead to more comprehensive and effective care for your child. In a world where medical knowledge is constantly evolving, embracing diverse perspectives is key to achieving the best possible outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1136/emermed-2016-206444, Alternate LINK

Title: Identifying Discordance Between Senior Physicians And Trainees On The Root Cause Of Ed Revisits

Subject: Critical Care and Intensive Care Medicine

Journal: Emergency Medicine Journal

Publisher: BMJ

Authors: Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur

Published: 2017-08-11

Everything You Need To Know

What did the Emergency Medicine Journal study reveal about disagreements between senior physicians and trainees in pediatric ER revisits, and what are the implications?

The study published in the *Emergency Medicine Journal* showed that senior physicians (attendings) and trainees (residents and fellows) often disagree on whether a patient's revisit to the pediatric ER within 72 hours is due to a potential medical deficiency. Attendings identified deficiencies in 13% of revisits, while trainees identified them in only 9%, resulting in a 17% overall discordance rate that increased to 25% for revisits requiring hospital admission. This difference in perspective can lead to improved patient care through constructive dialogue and uncovering hidden insights. While this study highlights the value of different perspectives, it does not cover the specifics of long-term care plans or the financial implications of revisits, which are important aspects of comprehensive healthcare.

How does involving trainees in revisit QA systems enhance their educational opportunities and contribute to improved patient care?

The study suggests that involving trainees in the review of revisit cases and reuniting attending-trainee pairs around these cases can serve as a novel educational opportunity. This collaborative approach allows senior physicians and trainees to share their perspectives, challenge each other's assumptions, and identify potential gaps in care. The integration of trainees in revisit QA systems also empowers them to develop critical thinking skills and contribute to quality improvement initiatives. Although the study emphasizes the educational benefits, it doesn't delve into the structured curriculum or mentorship programs necessary to maximize the educational value of these experiences, which are essential for fostering a well-rounded learning environment.

In light of findings on doctor's disagreement, what practical steps can parents take to advocate for their child’s healthcare during emergency room visits?

Parents can actively engage in their child’s healthcare by seeking second opinions, asking detailed explanations of treatment plans, and encouraging open communication between doctors and trainees. By understanding that disagreements among medical professionals can be a catalyst for better care, parents can advocate for a collaborative approach that considers diverse perspectives. Parents might also proactively inquire about the experience levels of the medical staff involved in their child’s care and encourage dialogue between senior and junior doctors. While parental involvement is crucial, this does not replace the need for standardized medical protocols and continuous training to ensure consistent and high-quality care.

What does the observed discordance between senior physicians and trainees suggest about the different perspectives in emergency medical care?

The discordance between senior physicians and trainees highlights that different levels of experience and training can lead to varying perspectives on patient care. Trainees may bring fresh insights and a more up-to-date understanding of recent medical advancements, while senior physicians offer a wealth of practical experience and a broader understanding of complex medical cases. This difference in perspective can lead to a more comprehensive evaluation of a patient's condition and the identification of potential medical deficiencies that might otherwise be overlooked. However, understanding the root causes of these disagreements would require further research into cognitive biases, communication barriers, and the specific training curricula of the involved medical professionals.

Why is reviewing 72-hour revisits considered a standard practice in emergency departments, and how does it contribute to quality assurance?

The review of 72-hour revisits is a standard practice for ensuring quality and providing important feedback within emergency departments. Hospitals analyze why patients return to identify gaps in care and implement changes to prevent future occurrences. This process traditionally involves senior physicians, but the inclusion of trainees has been shown to enhance the identification of potential medical deficiencies. The revisit reviews are often part of a broader quality assurance program that includes audits of medical records, patient surveys, and peer reviews. These comprehensive systems are crucial for maintaining high standards of care and promoting continuous improvement within medical facilities. Further details would be needed to understand the specific criteria used to define 'potential medical deficiency' in these revisit reviews, as well as the protocols for addressing identified deficiencies to improve patient outcomes.