Comments on: Blogfight!

By: Painless

Painless — Wed, 09 Sep 2009 21:01:57 +0000

Working the ED over the weekend.. Saturday was Flu day – 80% of patients came in with cc of flu sx and 60% of those cultured + for Influenza A and got tamiflu. The others? One r/o MI and a bunch of dentalgia and low back pain. Most of the care given is going to end up being charity. Unfortunately, it was once explained to me that you could not determine an emergency condition from triage. The determination of an emergency condition entailed developing a diagnosis. This might entail full lab workup, repeat labs, CT, MRI if appropriate and coming to a diagnosis. This is how it was explained to me, a humble ED Nurse. Funny thing is, 99.999% of the time, the triage nurse get’s it exactly right as what’s going on from an emergent vs non emergent perspective.
Why can’t the ED be more like a dentists office? You get to the back, get seen and the ED physician leaves and a financial clerk comes back with a treatment plan – and how much it would cost to continue continue that treatment.. I can see it now. “sir/ma’am, the ED physician has determined you have severe dental carries and a possible infection. The treatment plan is to start you on antibiotics and pain control. The portion you are required to pay today would be $400.00 (or whatever). We accept cash, mc, visa, amex and checks. How would you like to pay today?” Of course, the problem with this idea is that same person does not have money to pay for his care, nor insurance, so he goes home untreated and ends up dying from an abcess that extends into his brain. His family then sues the hospital, the physician, nursing staff and the financial personel because even though it was not an emergent problem at the time, the problem was diagnosed but not treated. Did the ED personel do anything wrong? I think not. But in the end, that is why we have to continue to treat everything that walks through the door despite ability to pay or whether it’s emergent or not. They can alway’s worsten and have a significantly worst problem that could cause disability or death, even if it’s indirectly.

By: ERP

ERP — Fri, 05 Jun 2009 21:22:47 +0000

“Dipstick”. Now that is a blast from the past of Roscoe P Coltrane!

By: Teresa

Teresa — Fri, 05 Jun 2009 15:16:02 +0000

In the town of 100,000 where I grew up, there is not a single urgent care clinic. Stop using such a broad brush on health care. You do not know what you do not know.

By: Newest EMTALA Violation? « WhiteCoat’s Call Room

Newest EMTALA Violation? « WhiteCoat’s Call Room — Fri, 05 Jun 2009 11:18:09 +0000

[...] « Blogfight! [...]

By: cynic

cynic — Fri, 05 Jun 2009 09:08:44 +0000

Do your trauma patients go to the operating “room,” aka OR, or the operating department?

By: Nurse K

Nurse K — Fri, 05 Jun 2009 01:22:48 +0000

Monkeygirl comes out of the woodwork for a blogfight. Gotta love that.

I think it’s sad that you left the ER, Monkeygirl.

I have a $25 front-row “co-pay” to watch WhiteCoat and MG fight. I know how to spend MY money wisely.

By: Nurse K

Nurse K — Fri, 05 Jun 2009 00:57:50 +0000

Best part of this whole thing is Scalpel called me a “Dipstick” in an email. It’s cute when he calls me his wife’s pet name for him.

By: k

Thu, 04 Jun 2009 21:40:30 +0000

The ED is for emergencies.

Sinus congestion is not an emergency. If you have to go to the doctor outside of work hours, suck it up and go to the urgent care. Even better, drop in at the Minute Clinic. You can buy a box of Sudafed while you’re there – no extra trip needed. .

I have no fondness for the health insurance industry, but IMHO more plans should slap stupidity taxes on people to discourage such idiocy. (Yup, my plan has a high ED co-pay, even when conditions warrant. The other stupidity tax of my plan is pre-auths for CT or MRI – no pre-auth, no coverage, unless it’s an emergency.)

Around here, you don’t even need an appointment to be seen without waiting in the ED. The Adventist hospital up the street has a “no-wait” ED – ostensibly, this was a deliberate design, but the no-wait property is said to be more effective than usual because most of their traffic comes with lights and sirens.

By: mercutio

mercutio — Thu, 04 Jun 2009 21:06:36 +0000

geez. thats as bad as the comments thread on ernursey’s memorial day post…

By: John

John — Thu, 04 Jun 2009 19:43:16 +0000

Looking for someone to start a flame war with WhiteCoat over ER/ED.

This debate is a lot more petty than the one referenced in the post.

ED in this sense is like the secret handshake for medical professionals. It is how they can show they are in the club because in the real world, ED is a disease treated with a little blue pill.