The hospital emergency room.

[Nev375]

I'll bet I can other more positive options.

It's my opinion that hyper drama, polemics and somewhat snarky remarks such as this do not make the world a better place.

I have to wonder how many people reading your post were lead to believe that was their only option.

Let's leave the drama etc at home.

After all we're saving the world here!

You are right. That was an overdramatic snarky response. I tend to do that when I am overwhelmed emotionally and cannot use the four letter words that are required to adequately convey the level of extreme frustration that I feel when someone suggests I'm either lying about actual true things that I've experienced or else there are deficiencies with my iq.

But to counter your assertion that there exists other options. No there are not. The situation is quite simple. There are no urgent care clinics in the area. There are no free clinics. There are no outreach centers. There is not even anywhere you can go to get your blood pressure accurately measured for free. Not even the fire department. Not even the ambulance barn. (Unless you call 911 and they come to you) Even the er will not take your blood pressure without admitting you. But they will happily admit you for it.

You see its a rather large hospital for such a small town and the er is rarely crowded, but they can charge you more that way.

And yes the local clinic and many doctors here will in fact turn away uninsured or unnatractively insured people and suggest the er. I strongly suspect that the local doctors get kickbacks from this arrangement because the only other hospital that is any bigger is 100 miles away.

They've denied service to both me and my wife at various times over the years under different insurance conditions.

*nods*. I'm slightly confused why people think doctor offices will turn away non-insured patients? There's been plenty of times when I paid for services out of pocket, with no insurance in site.

Not everywhere is like where you are.

In some places healthcare is downright predatory upon the poor

 

[Skeeter1]

It might not be possible to make those institutions profitable, but profit is neither a goal nor a guarantee that I've offered. Not all businesses succeed. And private ownership of hospitals in high poverty areas isn't an idea that I've even advocated.

My hope is for a nationwide health care system that costs less while delivering better care. Lower cost means somebody makes less money. I can't tell you that something will be cheaper and more profitable at the same time.

As for saying exactly what to do, that can't be an expectation of an informal discussion, because none of us are content matter experts, yet we are free to discuss issues anyway. And in my case, I'm hampered by the fact that what I advocate starts with gathering information:

Where is the money going?

Are you opposed to this? Why?

Where is the money going?

That's an easy answer technology and labor are major costs of a healthcare org. Risk costs, malpractice insurance and legal costs are astronomical. Also the capital costs and depreciation are screwed higher for US hospitals than other industries.

 

[Skeeter1]

It saddens me that you're at a level where you have access to this information, yet haven't heard of basic cost reduction measures that are widespread in the business world.

Cost reduction is SOP in the private insurance world. Utilization reviews, wellness programs, fraud investigations, best practices and quality review of physician outcomes have been done for years. Guess who traditionally has not had these programs, Medicare and Medicaid. Excluding some basic fraud investigations by Medicare these programs have just paid for disease cessation they are about 20 years behind the curve on disease prevention and wellness.

 

[Skeeter1]

NO POLITICS! Just saying. I would suggest not using the o word.

Not oxycodone.

I'll try but I am afraid just like Reganomics stuck, Mr. O's signature piece of legislation will forever carry the name that shall not be spoken here.

 

[skychief]

...I I too was amazed how many people there were using the ER for their primary care. One person even had a hang nail and was there to have his nail cut back by a doctor. Just a sign of the times.

Eyes wide shut.

 

[BawanaRik]

I'll try but I am afraid just like ********** stuck, Mr. O's signature piece of legislation will forever carry the name that shall not be spoken here.

That's clever.

 

[BawanaRik]

It might not be possible to make those institutions profitable, but profit is neither a goal nor a guarantee that I've offered. Not all businesses succeed. And private ownership of hospitals in high poverty areas isn't an idea that I've even advocated.

My hope is for a nationwide health care system that costs less while delivering better care. Lower cost means somebody makes less money. I can't tell you that something will be cheaper and more profitable at the same time.

As for saying exactly what to do, that can't be an expectation of an informal discussion, because none of us are content matter experts, yet we are free to discuss issues anyway. And in my case, I'm hampered by the fact that what I advocate starts with gathering information:

Where is the money going?

Are you opposed to this? Why?

Where is the money going?

I don't feel "gathering data" is what we need. We need to let people make their own choices. They have the data.

We need to respect individuals enough to allow them to live their own lives.

 

[BawanaRik]

My pop was admitted early this morning, and is still there for monitoring. He had a heart attack in 2006, a stroke a few years before that, and three stents. So extra precautions for people like him.

I was more concerned for my fathers welfare, but the people sitting around us with their little ailments were really pissing me off.

-Mike

The stents usually turn into a cabbage. All the medicine in the world can't make up for life choices.

Does he go to a gym? Walk wherever he's going? Eat right.

One of my fiends fathers had an bypass decades ago. The guy got down to 130 lbs won't look at red meat and drinks a glass of red wine with dinner.

He's in his 80s. No one thought he would hit 55.

 

[Dale D Dilly]

I don't feel "gathering data" is what we need. We need to let people make their own choices. They have the data.

We need to respect individuals enough to allow them to live their own lives.

I think the people offering to show them data are respecting them. It's the advertising, PR, political campaigning, and social media-ing folks who don't believe people are rational and capable of making their own choices--these are the folks that rely on sensationalism to entertain others into thoughtlessness.

I don't think our fundamental assumptions about individual responsibllity and rights are very different, we just think of communication differently. All of the folks I mentioned deliberately try to obscure the existing data for the sake of denying individual agency and controlling the masses. The folks who slow down and say, "Wait, I'll get you the data," actually want to empower people.

 

[spade2you]

My apologies for not being around. Holiday stuff with family.

So, here's how I avoided the ER today. I'm at Costco today. BIG mistake on my part. Wife calls me and tells me she thinks our son has pink eye. I do my best to get out ASAP. His office was open until noon and we were already too late.

I called their answering service and waited 20 minutes to leave a message for them to pass to a nurse. It took about an hour for the nurse to get back to me. I explained the symptoms. The nurse was going to call in a prescription to Target.

The nurse called back 20 minutes later. The next obstacle was that Target wasn't picking up their phone. We tried Walgreen's next. My insurance paid $2, making the prescription cost $14.

ER visit avoided. Also picked up some windshield wiper fluid for $2. Things are coming up Millhouse.

 

[Nev375]

If the same scenario had played out here you would have been given an appointment in 2 weeks time at best. And if that wasn't good enough you would have been directed to the ER.

Ive never heard of a prescription given over the phone without an office visit. Not even for renewing blood pressure or birth control pills. Thats amazing.

 

[spade2you]

If the same scenario had played out here you would have been given an appointment in 2 weeks time at best. And if that wasn't good enough you would have been directed to the ER.

Ive never heard of a prescription given over the phone without an office visit. Not even for renewing blood pressure or birth control pills. Thats amazing.

Either you're exaggerating how bad the clinics are or you quite possibly have the worst clinics in the US.

Had it been during office hours, they might have requested we see them and they would have done their best to make it happen. We might have had to wait, but no pediatrician worth their salt is going to let conjunctivitis turn into a bad case of pink eye. My kid's pediatrician has an after hours nursing help line and it's legal for them to get authorization from a physician to call in some eye drops.

Getting my kid to stop squirming so I can put in a drop is another story.

All of the above simply require patience, persistence, and problem solving.

 

[DerHoggz]

Either you're exaggerating how bad the clinics are or you quite possibly have the worst clinics in the US.

All of the above simply require patience, persistence, and problem solving.

Surprisingly, people have different experiences in many circumstances.

 

[spade2you]

Surprisingly, people have different experiences in many circumstances.

I hardly live in a land of special and unique opportunity. After hours on-call isn't that unique. Docs need to compete. If I found out the pediatrician didn't have after hours on-call, I'd be calling someone else and they'd get my business.

 

[DerHoggz]

I hardly live in a land of special and unique opportunity. After hours on-call isn't that unique. Docs need to compete. If I found out the pediatrician didn't have after hours on-call, I'd be calling someone else and they'd get my business.

Both are believable though.

 

[spade2you]

Both are believable though.

You'd need a total monopoly on the local area to require 2 weeks and no after-hours. Virtually impossible to pull a move like that in or near an urban area. Gotta remember your competition because they'll take your patients and eat your lunch if you're not careful.

 

[Nev375]

You'd need a total monopoly on the local area to require 2 weeks and no after-hours. Virtually impossible to pull a move like that in or near an urban area. Gotta remember your competition because they'll take your patients and eat your lunch if you're not careful.

You are correct. No comptetition and 100 miles to the nearest urban area.

 

[Steve]

Actually it can be solved. Merely closing the ERs to anything other than real emergencies with paying customers would go a long way to doing that.

So..the guy that shows up with a stomach ache and gets turfed only to die an hour later from an abdominal aortic aneurysm...too bad for him....

The guy that shows up with a headache and gets turfed only to die of a stroke an hour later...too bad for him.

The guy that shows up with a sore leg and get's turfed only to die of a pulmonary embolism an hour later from the deep vein thrombosis in his leg...too bad for him.

The guy that played tennis all day Sunday and has a sore neck Monday morning...that's the tennis and not the Monday morning heart attack...right?

That guy that showed up twice last week...the one that got turfed because it was just an anxiety attack..so he got a referral to a pshrink that we all know he can't afford...that guy?....When he goes home and pulls a rifle off the wall and starts walking toward the local elementary school...too bad for them...right?


How are YOU going to feel when it's YOU with a chest pain and shortness of breath and that triage nurse tells you to go home because she thinks it's the salmi you ate for lunch and YOU don't need to be in an ER.


I'm not at all sure that your Utopia is.

There are an near endless list of issues that are life threatening that do not present with extreme symptoms and you don't find those causes until you start the treatment process.

 

[blue4]

So..the guy that shows up with a stomach ache and gets turfed only to die an hour later from an abdominal aortic aneurysm...too bad for him....

The guy that shows up with a headache and gets turfed only to die of a stroke an hour later...too bad for him.

The guy that shows up with a sore leg and get's turfed only to die of a pulmonary embolism an hour later from the deep vein thrombosis in his leg...too bad for him.

The guy that played tennis all day Sunday and has a sore neck Monday morning...that's the tennis and not the Monday morning heart attack...right?

That guy that showed up twice last week...the one that got turfed because it was just an anxiety attack..so he got a referral to a pshrink that we all know he can't afford...that guy?....When he goes home and pulls a rifle off the wall and starts walking toward the local elementary school...too bad for them...right?


How are YOU going to feel when it's YOU with a chest pain and shortness of breath and that triage nurse tells you to go home because she thinks it's the salmi you ate for lunch and YOU don't need to be in an ER.


I'm not at all sure that your Utopia is.

There are an near endless list of issues that are life threatening that do not present with extreme symptoms and you don't find those causes until you start the treatment process.

+1

 

[blue4]

There are more patients than doctors even in some urban areas. There aren't many doctors sitting around with open appointments, or dentists for that matter, that I've found in the 20yrs since I got out of the service. Now, since I moved into a far better neighborhood this year, I've seen more urgent care places.