As I wrote this editorial, my 89-year-old mother had been hospitalized for 8 days after a fall in her home and a long-delayed diagnosis of hip fracture. Initially there was diagnostic uncertainty as various imaging studies were not definitive for hip fracture. Given my mother’s long-standing medical problems, including a history of venous thromboembolic disease and pulmonary embolism, diagnostic uncertainty resulting in days of bed rest in the hospital were a source of anxiety owing to the known medical risks of immobilization. The orthopedic surgeon explained to our family his reluctance to operate until he could establish a definite diagnosis of fracture. At first, my mother and other family members were invited by the surgeon to participate in the decision to conduct more testing. With the information the doctor provided to us, we accepted his advice and the possible risks involved in delaying surgery to allow for further workup.
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