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January 22, 1973

Standing Orders

JAMA. 1973;223(4):434. doi:10.1001/jama.1973.03220040048013

The old parade order, "Pass in Review," shouted sing-song by the regimental adjutant, more than ever has meaning for hospital medical practice. The command comes to mind regarding the orders physicians write on patients' charts, and they—the orders, not the patients—stand and stand and stand. Not that such things as medical audit and peer review (which mean different things to different people) and hospital accounting and personnel practices don't merit full attention for reasons of economy. Rather, one thing at a time; consider now only "standing orders."

An order that is allowed to "stand" may rarely represent sheer negligence, leading to disaster. For example, some years ago, Yater and Cahill1 described a patient, a 64-year-old riverman who made his living in the Potomac shallows catching minnows for sale to fishermen. He was brought to the hospital, jaundiced, having been ill for one week with daily chills and severe malaise.