So she has a femoral DVT? Doesn't really matter if she starts Coumadin in or out of the hospital, because she is now likely on therapeutic dosage of Lovenox, which can be given as an outpatient. Provided she has good follow up, Coumadin can be started then. Only problem is, Lovenox is pricey, so getting on Coumadin sooner is nice from a resource utilization standpoint. Basically, both docs are right, they are mainly disagreeing on style points.

Obviously, you haven't given us the full story, because why is your wife needing so much in the way of anticoagulation? Personal or family history of bleeding disorders? Personally, if my wife was getting DVTs easily I would suggest that she not undergo unnecessary procedures that promote blood cot formation. This post should not be considered medical advice.