When I was young, a visit to the doctor was and annual occurrence. at most, for a DPT booster...if something like a broken bone, or stitches, wasn't required. I remember four events that required a special visit. One was for stitching up my chin after trying to tight-rope walk on a bassinet. One was for a broken finger while playing dodge ball, one was for addressing red streaks running up my leg after being stung by a wasp, and one was for being knocked out, with a concussion, while playing softball in gym. Bad scrapes, cuts that didn't cause large open wounds, colds, flu, measles, mumps, and chicken pox were handled at home without a visit to the doctor. A visit to the ER was out of the question. That was for life-threatening events, which was decided by parents, emergency personnel, and finances.
Today, people go to urgent care, or emergency rooms, for things not contemplated as requiring such things in the past. A visit to either shows people ratchet-jawing on their phone as they wait for the doctor, or nurse practitioner. Very sick children I can understand, but when they're fidgeting, complaining, and don't show any sign of severe malaise, or injury, I wonder if there is really a necessity for the visit. That brings me to my question: What percentage of visits are medically necessary, and what percentage could have been handled at home, with over the counter medications? It seems the percentage is probably too high for unnecessary visits, but that's just an opinion.
IIRR- The emergency room has to see you no matter your financial (or immigration) status.
ReplyDeleteThey can't refuse treatment, so free Dr. visits and meds.
For real emergencies, without a form of payment, their demanded treatment is stabilization and a transfer to a hospital like in Galveston that is a teaching hospital and reimbursed by other sources.
DeleteThey can't turn you away if you're illegal or a deadbeat.
ReplyDeleteThat closed many hospitals near the Mexican border.
Delete25-year ER RN:
ReplyDeleteMost ER visits are unnecessary, and should have gone to Urgent Care.
If MDs didn't have a six-month waiting list for an office visit, Urgent Cares would be out of business.
Instead, they're literal life- and time-savers, doing exactly what you pay them for.
I've been to Urgent Care twice in the last month, and the ER once. Both Urgent Care visits were for RX scrips that no OTC would take care of. That's what Urgent Care is for.
The ER visit was for something serious, that could have turned into a hospital admit (it didn't, thank heavens).
If people only used the ER for emergencies, I'd be bringing books to work to read 3 nights out of 5.
But people are idiots, so I have job security forever.
90% of them come in for stuff they never should have bothered us for (the proof of this is that when it's rainy, walk-ins drop 75%, because their complaints are total b.s.). Another 5% wait too long to come in, because their low on money, low on IQ, or both.
The last 5% of the ER is actual emergencies that belong there. Some of those are things that could have been handled at Urgent Care, but it's 3 AM and none of them are open. You need stitches or pain medicine for a bum tooth then, I get it.
But when people bring in their kid (or their grown-up selves) for basically the sniffles, or chronic problems they've had for years, they should be berated, gently, and told to stop being stupid.
Unfortunately, as noted, the ER has to see everyone. People don't go to Urgent Care, because they can demand payment before seeing you. The ER can't do that, which is exactly the problem.
If we could demand a $50 cash copay, I'd see anyone. If it was a bona fide reason, we'd refund the $50. If it deemed was stupid sh*t, you'd lose it. But 99% of the b.s. in the ER wouldn't come in, including all the homeless just looking for the turkey sandwich B&B.
Without people who do go to Urgent Care, the average ER wait to be seen anywhere would be 20 hours, 24/7/365. People there should be on their cell phones, reading books, etc.
But when someone tells me their kid has abdominal pain 10/10, and I see him running around the ER waiting room, and eating a bag of flaming hot cheetos, or it's them, and they're texting with that 10 out 10 pain, I know they or mom is full of sh*t, and the kid's fine.
That's 20 times a night, everywhere I've worked, since forever.
That's why I refer to my job as "lifeguard in the shallow end of the gene pool". I'm not kidding.
That's what I've heard from many in the medical profession. To make things worse, one nurse told me people would come in for needed insulin, leave after being stabilized, and be given some until they are supposedly going to the doctor. The insulin would be sold on the black market, the diabetic would continue their venture, and eventually end up in the ER for advanced kidney problems. Dialysis would be the treatment for the most severe, and in the end, disposing of the body would too be paid for by those with insurance, or tax dollars.
DeleteConcur 100% My daughter was a paramedic for over 10 years and had 'stories' of 'frequent flyers' that called them multiple times a month to go to the ER! She recorded one calling ANOTHER ambulance from the back of her ambulance on the way home because she wouldn't take her to a level 1 trauma center for her hypochondria...
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