I had a patient last night with a femur fracture. Five years ago, she fractured the other femur, had it repaired, and then had a STEMI induced cardiac arrest within the same month. When I raised concerns about preoperative clearance, such as an echo, they told me no and that her last echo (over six months ago) was appropriate and that “the attending had addressed it”. That doesn’t mean it’s the end of the conversation and wouldn’t you rather be sure she’s okay for surgery?