While doing so they often overlook the reality that the next facility is far away and the patient may deteriorate on the way, or that the patient may not have the resources to access care, or that family circumstances may make the referral difficult. Such a decision may turn out to be hazardous and may even sound the death knell for the patient. Few physicians however follow a different path, by trying to manage the patient themselves to the extent possible. They either take an informed decision to treat the patient themselves, accepting the consequences; or they work to stabilise the patient first and then consider referral. These acts are what may be called as “clinical courage”, where one goes beyond the usual and enters into a previously unchartered area, to manage the patient in the best possible way.
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