Tonight I encouraged my fellow to admit a heart patient to the medicine service. She needed a pacemaker. Any intern in the hospital can call the electrophysiologist to see her, so the fellow was inclined to “dump” to medicine. *NOTE* A dump is when one service or physician sends the patient to another physician or service when the first service or physician was completely capable of caring for the patient. I encouraged him to do so and now I feel guilty. In the time it took for the fellow to call the medicine attending and tell him that the medicine intern could just as easily call the electrophysiologist as the cardiology intern could, I could have written all the orders and had the patient admitted, and avoided listening to the awkward phone call between the fellow and the attending. Next time I’ll just tell the fellow we’ll take the patient. Ugh.