More data for the "please don't immediately recommend the ER" cause

[feckalyn.livejournal.com]

Friendly mod post here y'all~

Some of you know about my crusade to try to limit the use of our dwindling Emergency Rooms to true emergencies only. Here's my last post on the matter.

Anyway, the CDC released a report on the status of Emergency Department use in the US this week. And the news isn't great.

"A record 114 million Americans visited a hospital emergency room in 2003, despite a steady decline in the number of E.R. facilities available nationwide, the U.S. Centers for Disease Control and Prevention said in a report issued Thursday.

While E.R. visits shot up 26 percent over the decade from 1993 to 2003, the number of emergency department facilities fell 14 percent over that span."

See more in the CDC's report.

So when you see fellow vp-ers asking for medical advice, please refer them to a local ask-a-nurse line (usually available though community hospitals) or their personal medical provider rather than the ER. I know I want to have access to ER care when I'm having a medical emergency and I'm sure you do too, but if we keep misusing them they aren't going to be there when we need them!

Comments

[anachronista.livejournal.com]

Amen! My dad's an ER doc and you wouldn't believe the stupid crap people have come in there for. When he was doing his residency in Miami, he had to "perform" an exorcism for a woman's grandchild.

[feckalyn.livejournal.com]

I had a friend that worked in medical transcription and he said that the lamest one he ever saw was an ingrown toenail!

Now, I understand the plight of the un/underinsured in the US and how totally fucked up our medical system is, I really do....but wow!

[anachronista.livejournal.com]

If I were the doc, I would've amputated. Just to show the guy that the ER is for emergencies only...

ha ha - juuuust kiddin'

[feckalyn.livejournal.com]

Or maybe insisted that he needed a urethral swab just to rule out some sort of rare STI that causes toenail swelling :)

[anachronista.livejournal.com]

ooh! That would totally be necessary.

We should open an ER.

[feckalyn.livejournal.com]

feckalyn and anachronista's house o' pain/ER

I get to do all the swabs and catheters! :)

[anachronista.livejournal.com]

Aw man! You get to have all the fun!


Ok - I get to do prostate exams.

eeeeeeeeeewwwww.

[mynameismaryjo.livejournal.com]

yikes. i'm never going there!

[feckalyn.livejournal.com]

Exactly our point! It worked!!!!! ;)

[preternatural.livejournal.com]

"While you're reading the definition of the word 'emergent' and writing a followup essay on what it means to you, I'll be removing your toe..."

[nephron.livejournal.com]

One of my friends works in an ER, and she had someone come in with grass stains on their knees. Kid you not.

[xbeautyinsidex.livejournal.com]

Wow, no kidding? That's just weird...

[dial-zero.livejournal.com]

Yep, I remember when someone here posted about finding a pinworm and got like 10 responses saying: "ER. NOW." Really, pinworm is about as serious as head lice, right? Yeesh. Your last post gives excellent reasons to not head for the ER for every last thing.

The one time I visited the ER there was a sign on the wall saying that they cannot refuse to treat you even if you can't pay. But that doesn't mean they won't come after you for the money later, which the sign didn't say. I guess this is where people get the misconception that ER visits are free if you're poor. It's a fine line to walk, because if they added a "but you have to pay later" stipulation to the sign, people might be scared away from getting care that they actually need.

[strand3d.livejournal.com]

I don't know many ER's that just let you get away with not paying. I work for an ER doctor and we bill everyone he sees. If you don't have insurance, and you refuse to pay, you're going to a collection agency. It sucks, but don't go unless you're really sick, ya know?

[feckalyn.livejournal.com]

There are a few ER's that are categorized as "Indigent Care Facilities" and they have public funding so that they can write off care for the poorest patients.

Unfortunately there is a very common misconception that all ERs provide this service and that is a huge part of the problem. The more people who show up at the ERs the more fiscally stressed they get the more they have to shut down.

I heard a state senator on NPR stating that every citizen of his state had access to health care because everyone could go get served at the ER. Well yes, they can't turn you away, but they're going to charge you something like 8 times what you would pay for an office visit for that privilege.

[dial-zero.livejournal.com]

I imagine that all the medical professionals listening to the show *headdesked* simultaneously. Do you know if anyone set the senator straight?

[feckalyn.livejournal.com]

I imagine so on the headdesking, and there was no correcting this guy.

He was a rabid republican and an idiot to boot. Interestingly a lot of conservatives hold the idea that ER = health care for all.

My fav. quote from him was on the topic of requiring insurance companies to cover contraceptives. He said to me:

"If a man is going to avail himself of the opportunity to become a father, he's going to have to take some responsibility."

So, you can see, perhaps, that trying to educate this guy was pretty pointless. Fortunately he was voted out last term :)

[willow-starr.livejournal.com]

Here in Ontario we have Tele-Health a free government phone service where you can talk to a nurse. It really stresses the "no stupid phone calls" and will tell you if a probelm should be seen by a doctor, taken care of at home, or if you should go to the ER.
1-866-797-0000 TTY : 1-866-797-0007

[squirt82599.livejournal.com]

Lamest ER things I've seen (I work in an ER)

* "I bit my tongue"
* "I have this stuff on my teeth...* (she ran out of toothpaste

[xbeautyinsidex.livejournal.com]

...
I seriously don't even know what to say about that last one...DANG. People are lame.

[vampodrama.livejournal.com]

I have been to the ER exactly once in my life. actually in my country that's a bit different, it's nothing like I've seen in the movies or TV - the real-deal ER (emergency medical help) is a separate unit where you don't have access of your own (you need to be brought there, not walk on your own two feet) and the place where you can go on your own is for treating traumas. for example, if you chop off your hand from the wrist you have two choices: call an ambulance or go to the trauma room on your own, but you'll end up in different facilities either way. also, if you chopped off your hand, it means you're able to walk, which means the ambulance might not come at all XDXDXD

I was to the trauma room due to my cat having bitten my hand so hard it was drastically swollen, infected and completely immobile. first off I was scolded for not having gone to a doctor earlier (it was two days after the biting), then I was scolded for not having turned to my own doc, then I was given some sort of a bandage and THEN I was the laughing stock of the entire hospital (my co-worker and the doc who treated me live in the same apartment building. it's a small town XD)

[shes-unreal.livejournal.com]

At my university's hospital, there's actually an inpatient clinic adjacent to the ER. Once I went there very early in the morning (for something heart-related, not vagina related) and the clinic was open while the ER wasn't. Don't ask me why!

[sparklesistah.livejournal.com]

My little bro went to the ER when he drank petrol haha. I don't think i've ever been. We call it Accident and Emergency here, but if you have something, like I broke my nose and my Doc told me to go to A&E to see the Docs there.

[sweet-tea79.livejournal.com]

As a former EMT, and a future ED doc (only 2 more years! yippee!!), thank you. Please keep the ED free for actual emergencies.

[sogn.livejournal.com]

My insurance is from a HMO, and sometimes I have to wait up to two weeks to get an appointment with my regular doctor. My only other choice is the ER. I've never gone to the ER, but I can imagine situations where going to the ER for a non-emergency would be better than waiting two weeks to get seen for something that could potentially get a lot worse in that length of time.

Like once I had a mild sore throat, and the next appointment available was a week away. By that time, my throat was so bad I couldn't even swallow (strep throat). If I had been able to go to a doctor right away, I could have gotten some medicine, and I wouldn't have had to go through all that pain.

This is the fault of HMOs, for requiring that you pick a primary care physician and then not allow you to go to any other doctors without a referral.

[sparklesistah.livejournal.com]

You have to get a referral? Wow, I don't think i've ever seen the same doctor twice. If I need to see a doc, I get a choice of who is on that day and when they're available, and I pick one that's most convenient for me. Seems like a better way to do things, I mean they all get my file with the same info in it heh :)

[lottasmiles.livejournal.com]

You may want to check into something like an "urgent care" center near you (usually attached to the ER or at least near it). It's like a place in-between a regular doc and an ER for situtations like the one above. I have heard it called various things in different areas, but maybe call you HMO or regular doc just to find out if there is one near you. HMOs tend to like it because it's not a full blown ER and therefor usually less expensive.

[sogn.livejournal.com]

No, I would need a referral to go to an urgent care center, or else the insurance company wouldn't pay for it. Basically they say that if you can't wait to go to your primary care doctor, you should go to an emergency room.

Yes, it makes absolutely no sense.

[unwanted4ever.livejournal.com]

I also have an HMO and my doctor has been in india for a month, and i was throwing up every time i ate for about two weeks, and it was'nt the flu so i tried going to another doctor and they said i needed a referral and i was like "well where the hell do i go?" and they told me to go to the express emergency (which is like the ER for people with problems that aren't as severe)and my costs were completely covered.

[lottasmiles.livejournal.com]

Well, that really surprises me. I am not doubting you, but after working in insurance for quite some time I have just never heard of that. I've always seen that ERs and Urgent Care centers are covered in the same way, they just take different cases. That's why they are usually attached and some ppl entering the ER end up in urgent care and never even notice.

Some HMOs do prefer/require a call into their center first or to an advice nurse, but going to an urgent care center that works with your covered ER should not be a problem. I'd bitch a fit if it was. I'm sorry your insurance is so tight in policy.

[lizs18.livejournal.com]

In my experience the reason many people 'misuse' emergency rooms is because they do not have access to other forms of medical care. If everyone had access to adequate medical care, I don't think this would be much of an issue and a campaign for adequate medical care for all, would, in my opinion be more effective.

Yes!

[feckalyn.livejournal.com]

I agree 100%. I am totally passionate about a single payer health care system where we all have health insurance that's not attached to our employment. I just don't think there's too much I can do about that here on vp besides advocate that we use our dwindling resources wisely. Now I'm sincerely wondering, how would you use vp to campaign for adequate medical care for all US citizens? Also, do you think uninsured/underinsured people should use the ER as their primary method of health care? And if so, what do you see as the benefits to them and society?

Have you read Healthcare Meltdown: Confronting the Myths and Fixing Our Failing System? It's an amazing book. It really does a great job of detailing the ills of our medical system and has a great solution for making it better.

Re: Yes!

[lizs18.livejournal.com]

What I would advocate for, is that people try their best to utilize local health clinics and health departments to meet their needs and that if those resources aren't available (which they aren't in many cities and counties) that they contact their elected officials and let them know that they would like those resources to be available. I see the emergency room issue as a symptom of the disease, and I hesitate to caution people against using what might be their only available access to medical care. I think that people should receive medical care, and should use the best resources available, and I realize for some, emergency care is the only resource available. The benefit to them would be that they receive necessary care.

Lack of access to necessities have few benefits to society in my opinion. The only benefit that people using emergency services as a clinic when one isn't available to them, might be that they get upset about the lack of access to medical care and begin, or continue agitating to change that.

VP might not be the best place to campaign for health care access for all, but I doubt people would be offended by providing a link to other organizations, or providing information about grass-roots efforts.

Re: Yes!

[feckalyn.livejournal.com]

I see what you mean about the ER situation being a symptom of the bigger problem and I agree, but I don't personally feel that telling people on an internet forum to use them indiscriminately is the answer. (Which does happen here quite frequently..."oh, you think maybe got Pin Worms? Run, don't walk to the nearest ER!!!!!!!!11!!")

What about when all the ERs are closed because they can no longer afford to run because the 43+ million people who are uninsured (and probably twice that who are underinsured) in this country used them for non-emergent situations because someone on vaginapagina (or elsewhere) told them that they should? Or if they close their doors to all but the well insured? Do you think that's going to make the situation better? Now not only are people who don't have insurance not receiving health care, they won't have access to emergency care in case they have a true emergency, and neither will most other people.

And, while I agree that nobody would likely be offended, vp is not a grassroots organizing community for universal health care. And nor are most of our members medical professionals, so recommending that people who post here go to the ER (in the vast majority of circumstances) is completely innapropriate.

Re: Yes!

[touchyphiliac.livejournal.com]

Recommending that people not go to the ER is only effective IF THERE ARE OTHER OPTIONS AVAILABLE. Which in many cases there are not.