Rant: Emergency Room abuse?

[jdinca]

I'm sure I'm gonna take some heat for this but with the news talking about how overwhelmed ERs are with flu cases, I have to air a long time issue in the emergency medical world. Unless you're very old, very young, medically compromised (immunodeficient, etc.) why are you going to the ER for the flu? What exactly is it that you expect them to do for you? Antibiotics are for infections, the flu is not an infection. Fever? Take tylenol and a tepid bath. Dehydrated? Drink water, it takes longer than an IV but it costs many hundreds of dollars less. Stuffy head? Headache? There are many OTC remedies for these symptoms.

The point is, and I've watched it get worse over the last 25 years, is that people consider the ER to be their personal physician. If you have insurance, you most likely have a PMD. If you don't, there are clinics available for the indogent. The flu is the just the most prominent issue because it's so widespread but there are many, many others that fall into this category. Previous generations would not have even thought about going to the hospital for most of these things.

Frequent answer to the question "did you call your doctor?" "Oh yeah, I guess I could have done that."

Don't even get me started on people who dial 911 so they don't have to sit in the waiting room.

 

[Sapper6]

i understand your concerns.

you'll often find that there are some people without medical insurance that will use the ER to get medical attention because they know a physicians office will not let them leave without paying something. the ER is not this way. of course you'll get billed, ALOT, but no money up front before leaving. can you blame them? most of these same people can't even afford Tylenol without sacrificing a utility bill of some kind.

an Emergency Room is for emergencies. what constitutes an emergency to some would be otherwise to others. who cares.

me on the other hand, i'm in the military. i'll go anywhere i choose to seek medical attention, be it a doctors office, ER, or MTF, and not pay a penny. why? because i can.

 

[jdinca]

i understand your concerns.

you'll often find that there are some people without medical insurance that will use the ER to get medical attention because they know a physicians office will not let them leave without paying something. the ER is not this way. of course you'll get billed, ALOT, but no money up front before leaving. can you blame them? most of these same people can't even afford Tylenol without sacrificing a utility bill of some kind.

an Emergency Room is for emergencies. what constitutes an emergency to some would be otherwise to others. who cares.

me on the other hand, i'm in the military. i'll go anywhere i choose to seek medical attention, be it a doctors office, ER, or MTF, and not pay a penny. why? because i can.

I'm well acquainted with the plight of the poor and, believe me, I do sympathize. I've transported people who dialed 911 not because they had an emergency but because they didn't have money for a cab. I now work in a very affluent community and deal with some of the same type issues but for different reasons. The latest being "I dialed 911 because I didn't want to sit in the waiting room". Socio-economics is only part of the issue. I think the "age of entitlement" has just as much to do with it, along with other things.

As for what constitutes an emergency, I do care. Especially when it takes a paramedic unit out of service to transport a healthy adult with the flu or a sprained wrist. Dealing with urgent or minor cases is having a detrimental impact on the ability to care those who really need the services and for those of us who have to foot the bill. I have a problem with paying increased health care cost because of the "bad debt rate" which is higher in emergency services than in any other branch of medicine.

As for your situation in the military, you have excellent health care and deserve every bit of it. I don't mind footing the bill.

 

[Andrew Green]

It's not just a poor thing, people hit the emergency room for all sorts of non-emergencies up here too, and doctors don't give you a bill.

 

[Sapper6]

I'm well acquainted with the plight of the poor and, believe me, I do sympathize. I've transported people who dialed 911 not because they had an emergency but because they didn't have money for a cab. I now work in a very affluent community and deal with some of the same type issues but for different reasons. The latest being "I dialed 911 because I didn't want to sit in the waiting room". Socio-economics is only part of the issue. I think the "age of entitlement" has just as much to do with it, along with other things.

As for what constitutes an emergency, I do care. Especially when it takes a paramedic unit out of service to transport a healthy adult with the flu or a sprained wrist. Dealing with urgent or minor cases is having a detrimental impact on the ability to care those who really need the services and for those of us who have to foot the bill. I have a problem with paying increased health care cost because of the "bad debt rate" which is higher in emergency services than in any other branch of medicine.

As for your situation in the military, you have excellent health care and deserve every bit of it. I don't mind footing the bill.

i agree completely with your rationale. especially coming from an EMS point of view.

i believe, in a larger city, this would have more of an impact on EMS services than say, in a smaller rural area.

i certainly wouldn't advocate the use of an ambulance to get a fever checked out. i would instead show them the quickest route, on their own dime.

 

[jdinca]

i agree completely with your rationale. especially coming from an EMS point of view.

i believe, in a larger city, this would have more of an impact on EMS services than say, in a smaller rural area.

i certainly wouldn't advocate the use of an ambulance to get a fever checked out. i would instead show them the quickest route, on their own dime.

It's a tremendous impact on big cities with large poor populations and high call volumes. The money drain is horrendous. Back in my pure EMS days, the company I worked for had a 60% bad debt rate, meaning they only collected 40% of billed services. It's worse now. I'm fortunate in that I'm no longer work in that situation and have the luxury to sit back and *****.

Unfortunately, we cannot refuse to transport. I can strongly suggest, but if they insist, we have to take 'em.

I also have to get cats out of trees, birds out of chimneys, ducks out of storm drains.......

 

[Lisa]

A few years back my dad got brought into the emergency room via ambulance, he was in bad shape. By the time I was called and went down there the doctor was with him, I was asked to wait in the waiting room until I could see him.

Anyways, the place was jumping, ambulances were pulling up, seemed like one every 15 minutes or so. One ambulance came in escorting an elderly lady, she was taken to the back assessed and then put in a wheelchair and brought to the waiting room. Shortly after her daughter showed up and freaked that her mother was in the waiting room screaming at the admissions nurse that she should have priority, after all she came in an ambulance.

The Nurse was great and kind and patient and explained to this lady that there were just people more in need of their time at this moment. Finally, the lady came and sat down, still absolutely fuming and exclaiming to her mother how she just didn't have the time to sit here with her and could not understand why she was not being taken in immediately because she had shown up in an ambulance.

Needless to say, as she ranted and went on just about everyone's face in the waiting room was that of shock and disbelief. We were all speachless that someone would use our already stressed emergency services to transport her mother so they could jump ahead of everyone else.

When I left a few hours later, she was still sitting there, so was her poor mother.

Abuses like the one I stated above burn me badly but I feel for those that use the ER to an extent. Right now if I want to see my family doctor, I will be lucky to get into them within the next two weeks. Doctor's are overloaded with patients and you make an appointment, you are lucky to get in within an hour of said appointment, over booking is a common practice. It is truly a sad state that our health care system is in. Many doctors are not taking new patients either because they can barely keep up with the ones they have.

The lack of availability to a doctor is definitely one of the causes of the ER being used in that way.

 

[Eternal Beginner]

I've spent A LOT of time in emergency rooms this fall with my father. Because of the severity of his illness he was always first priority so he never had to wait but I still spent quite a bit of time in the waiting rooms while he was being cared for. It was appalling how many people were there because they had very minor problems such as severly ingrown toenail in one case to a fingernail that was just hurting "really bad" because she had bent it backwards.

I also train with a guy who is a paramedic and at least twice while I was in emerg with my dad he was there waiting because the patient he brought in was NOT a priority so he had to wait until they were seen. In one case he, his partner, and an ambulance were kept off the roads for 2 1/4 hours while they babysat their intoxicated patient because there were more serious cases ahead of him. What a waste of resources.

 

[sgtmac_46]

I once found a vagrant gall who stated she wanted an ambulance. When it arrived, she demanded transport to a hospital two counties over. After they took her there, she hopped out of the ambulance and took off walking. She just wanted a ride.

 

[MJS]

I'm sure I'm gonna take some heat for this but with the news talking about how overwhelmed ERs are with flu cases, I have to air a long time issue in the emergency medical world. Unless you're very old, very young, medically compromised (immunodeficient, etc.) why are you going to the ER for the flu? What exactly is it that you expect them to do for you? Antibiotics are for infections, the flu is not an infection. Fever? Take tylenol and a tepid bath. Dehydrated? Drink water, it takes longer than an IV but it costs many hundreds of dollars less. Stuffy head? Headache? There are many OTC remedies for these symptoms.

The point is, and I've watched it get worse over the last 25 years, is that people consider the ER to be their personal physician. If you have insurance, you most likely have a PMD. If you don't, there are clinics available for the indogent. The flu is the just the most prominent issue because it's so widespread but there are many, many others that fall into this category. Previous generations would not have even thought about going to the hospital for most of these things.

I won't speak for every hospital out there, but from the ones that I've seen here in CT., the people are prioritized by the nature of the illness. People think its going to make a difference if they walk into the ER and complain about the flu. They're going to be sitting for a long time. If someone comes in with chest pain, you can bet that person will be seen first!

Don't even get me started on people who dial 911 so they don't have to sit in the waiting room.

I had to laugh when I read this. As a dispatcher, I take some calls that I sit there and shake my head at. They are not denied medical attn. but some things that people get an ambulance ride for, are IMHO, a serious waste of resources. And these are the same people that think that by coming in via ambulance they're going to be seen sooner.

Mike

 

[jdinca]

I won't speak for every hospital out there, but from the ones that I've seen here in CT., the people are prioritized by the nature of the illness. People think its going to make a difference if they walk into the ER and complain about the flu. They're going to be sitting for a long time. If someone comes in with chest pain, you can bet that person will be seen first!

Hospitals do prioritize but all those patients still have to be scene. Ambulance patients get priority because that unit has to get back in service. Someone in the waiting room with the flu will have to wait while someone on an ambulance gurney with the flu will get their bed.

I have taken obvious system abusers right to the triage nurse in ER registration, instead of the ER, MUCH to their surprise and chagrin.

I prefer it when I'm on the engine. We still run some medicals but we don't have to take anybody anywhere.