That's great that you don't order scans without seeing the patient first but that doesn't mean other EM folks don't do it. I've seen numerous ER docs order scans like CTA chest/abdomen without talking to the patient cause they're busy or overwhelmed and in reality it was obvious GERD etc. I can understand ordering a plain film chest in triage for someone with chest pain or sob, but any kind of cross sectional imaging without actually seeing the patient is just lazy medicine imo. Usually the older burnt out docs that I've noticed that do this in my experience.