I posted this to some other subreddits, and someone recommended sharing this here too.
My dad was a general surgeon in the ER. The hospital was collecting some internal info on who was doing what jobs, and it turned out that the ER was having a lot of non-cardio specializing doctors doing EKG's. The reason for this was pretty simple: The cardiologists tend to be busy, and the results in the ER have to be read really, really, fast. In order to be fast, they'd just read the EKG's themselves, as the results generally weren't subtle. It can be hard to tell some heart problems from others, but in the ER, all you really need is a quick peek to go "Ah, shit, this guy is having a heart attack."
The cardiology department got upset about this and said that ER doctors shouldn't get paid for doing EKG's as it isn't their specialty. The ER management was pretty chill, so the said that they didn't really care who did the EKG, they just needed the results to be in within 30 minutes of them being requested.
For the first few days, this just resulted in the doctors on the floor reading the EKG's unpaid. Not a huge deal, but kind of a nuisance.
Then during a night shift, my dad sold the other ER docs on an idea:
The first part of the idea comes from a hospital policy: Technically, if a patient came in with chest pain, you had to do an EKG. The ER was infamous for being swamped, so management turned a blind eye to the actual enforcement of this policy as a way to save time. If someone comes in with chest pain and a hacking cough, for example, they're probably not having a heart attack, they probably have pneumonia, and you should start your diagnostic with that.
This combined with the second part of the idea which was, what if the doctors actually rigorously self-enforced the first policy and asked for an EKG on all chest pain patients, while following the second policy of handing the EKG's to the cardio department? Either cardio crumbles first and lets them just do their damn just, or management crumbles first and removes the silly EKG rule. Either result is a win, EZ PZ.
Thus began the most brutal two days of the cardiology department's life. The ER handles a much, much larger flow of patients than the cardiology department is prepared to deal with. They're a specialist division, so they're not supposed to handle a particularly large volume of patients in a single day. This meant that they quickly got swamped by the sheer flow of patients in from the ER.
Oh, but it gets worse: ER docs work ungodly hours, and when the staff set up the deal, there was the agreement that the cardiologists had to get the results back within 30 minutes, and the cardiologists were getting a request for an EKG every 25 minutes or so. They could handle the reading that fast, but as the doctors were on call, they'd get only another 15 minutes or so to try and sleep before they'd get woken up to read another chart. Again, and again, and again.
By my dad's guess, the ER kept the entire cardiology department up for about 40 consecutive hours before they begged for a surrender. A second meeting was held, and the cardiologists demanded to be released from the previous policy. This was granted, and peace returned to the hospital.
Source: Original link