Orthostatic BP and pulse have great value, perhaps as much value as any physical diagnostic skill.  Patients with syncope, newly elevated BUN and creatinine, and patients with known GI bleed should always have orthostatics measured.

I always did them myself – as a resident and as a clinic physician.  Recently I see housestaff ordering orthostatics, or just ignoring their value.  I am befuddled, confused and disappointed.

Orthostatics take around 5 minutes, but those are 5 minutes spent with the patient, observing the patient, taking with the patient and gaining valuable information.  Am I being unreasonable when I expect the students, interns and residents to measure their own orthostatics?

When did this become an order for someone else to do?