OK, fair point. I hear what you are saying. If it was an aneurysm he would have been right to ask me to forego everything else and get her to hospital asap. Sometimes Dr does know best. I aint a doc, nor do I think I am. And yes, some of us can be procedure driven and sometimes a little knowledge can make us think we know more than we actually do. If it was a suspected aneurysm I would have to eat humble pie and just be an emergency taxi driver. That would actually be the best treatment for the patient. But I met this GP as he was leaving the patients house and we had a brief chat about the lady. There was nothing wrong with his examination and clinical findings. Classic MI story, no indication of aneurysm. He was correct in his diagnosis and the ecg he didn't want me to do helped confirm that. What got me were his comments to me about her being elderly and that being reason enough for him not to treat her and furthermore to specifically try to make sure I didn't either. It's the first time I've met someone who has deliberately tried to stop me from giving what they agreed was the best course of treatment for a patient based on what seemed like nothing more than their own whim. He couldn't defend his request when politely challenged on it other than the elderly, let's not worry her stuff. It was too unusual a request to comply with without further information. This was the first episode of ill health this woman had had for years. She lives an independant, happy and fullfilling life and may have a good decade or more of quality life ahead of her. She wasn't at the end stage of some chronic disease which may have to be taken into account in other circumstances. We're talking elderly here, not ancient. Fit as a fiddle and all that. The docs in CCU were none too pleased with him and may take the matter further. I'm guessing you are a doc yourself. Thanks for the link to that blog. Will peruse it at my leisure. If I'm giving this GP an undue hard time I'm not too proud to listen and learn. I would add as well though that while we might not have all the knowledge of docs, experience is a great teacher and after seeing plenty aneurysms and MIs over the years I would hope that I would seldom miss one now. The paramedics mentioned in the blog are no more representative of most of us than the GP I met is of doctors. The mere mention of the 'A' word is enough to have most of us getting our pt to hospital pronto. The sooner I can pass them on to you the better. An MI I can do something about, an aneurysm I can't. I've had enough bad experiences to try and work out the difference. I'd rather they expired on you than on me!