WhiteCoat

Healthcare Update — 05-24-2012

Another reason that I like sushi. Man goes to hospital for abdominal pain. Doctors believe he has appendicitis. Surgery shows that he swallowed a 1.5” bristle from the brush he used to clean his barbecue and the bristle had perforated his colon.

Six Indiana emergency physicians resign after hospital outsources contract to national emergency medicine contract management group.

CDC reports that 80% of people who use the emergency department do so because they have no access to an alternate physician (.pdf file). 48% of patients went to the ED because their physician’s office was not open and 46% went to the ED because there was “no other place to go.” But don’t worry, patients! Health care reform will give you health care insurance! And you still won’t have access to an alternate physician. Remember one of WhiteCoat’s rules: Health care insurance doesn’t guarantee you access to health care any more than automobile insurance guarantees you access to a car.

Knoxville, TN area hospital closes its doors. Now patients in the town are 40 miles away from the nearest open hospital. Community member aptly states “people will die because it’s not open.”

Peninsula Hospital in Long Island closed its doors last month because New York State wouldn’t provide the hospital lab with appropriate certifications. Now that summer is here, beachgoers who suffer injuries or near-drownings may not get to the next closest hospital for timely treatment due to increased travel times.

The down side to patients considering medical tourism: ““If something goes wrong, they are in deep shit.” Man chronicles story of son who went to Thailand to study. Developed weakness in foot and died 11 days later. Father believes son was murdered for black market organ harvesting.

Hey! You’re not Debra Peel. You’re Joanne Doroshow! Illinois brainiac tries to get prescriptions from the emergency department by giving different names at different hospitals. Now he’s in the Greybar Motel.

9 Responses to “Healthcare Update — 05-24-2012”

  1. Matt says:

    “Community member aptly states “people will die because it’s not open.””

    So move closer. There is no “right to a hospital down the street.”

    WC, your editorial angle seems to be that these hospital closings are bad because “people might die”. Maybe I’m misinterpreting you, but if not I think that’s a dangerous position for a healthcare provider to take. It only further ups the cry of healthcare being a “right”, which makes its providers less independent.

    • WhiteCoat says:

      My editorial angle is to show how hospital closings are affecting access to care. I agree with you that there is no right to health care and that there is no right to have a hospital down the street.

      My intent is to show that the current cost-cutting measures that the government is taking – decreasing payments to hospitals and providers, aggressively auditing “overpayments” (and I fully admit that fraud exists, but that can also be better addressed before payments are sent), and increasing regulatory hurdles – may be achieving their goals, but it is at the expense of a decrease in health care quality and access. Perhaps the government wants this. Fewer providers and fewer hospitals translate into fewer payments to providers and less money spent on health care.

      Unfortunately for patients, as hospitals close and doctors leave practice, there is progressively less medical care available overall. At the same time, emergency department patient volumes are significantly increasing each year.

      There’s no “right” to have nearby medical facilities, but society has to consider different approaches to controlling health care costs before the entire system crumbles.

      • Matt says:

        I appreciate that more nuanced position.

        And I understand access may be declining in some areas, but is that the case overall? And what’s more, what’s the optimal level of healthcare.

  2. throckmorton says:

    “no access to an alternate physician”. This drives me crazy. In our ER they have access to cell phones, chromed auto aftermarket equipment, $200 shoes and entitlement attitudes. They come to the ED because they will get what they want for free instead of going to the clinic in Wallgreens which is right down the road.

  3. defendUSA says:

    WC…as an ER Doc..what are your thoughts on this…2 days ago, my son got a cut over his fourth knuckle horsing around at school when it hit someone’s tooth and Brace. The mouth being the dirtiest cavity I can think of, I cleaned it and said we need to watch it. 24 hours later, my daughter calls me at work and says that kid 4 has a red line near the abrasion going up his arm. I call my family physician and the receptionist tells me that he can’t be seen, there are no appts, thereby forcing me to either utilize the ER or an urgent care. I was pretty pissed off that a receptionist can make this type of decision.

    Isn’t this the type of thing you would prefer not to see…It was not life threatening, but it needed attention and it would have cost me a minimum of a thousand dollars for an ER visit and you the time away from a true emergency. (I took him to the UC up the street and it was 2 hours of waiting, and an Augmentin RX with PCP F/U.)

    • WhiteCoat says:

      Part of the problem is that many people think emergency departments are just for life-threatening cases. They’re not. And even if they were, how are most people supposed to know what is and is not a life threat?
      If emergency departments only treated emergencies, there would be a lot of ED staff out of work. The smaller cases are the “bread and butter” of the emergency department. Only problem is that when there are more serious cases, the less serious cases have to wait.

      You son’s condition has the potential to be serious. Bite wounds/mouth punches – especially over knuckles – have a potential to infect a joint, infect the tendon sheath, or lacerate the tendon. There is a high incidence of infection from these types of wounds. This is the type of thing that should have urgent care. However, the urgent care needs to be from someone who knows what to look for and has experience in looking for it.
      Augmentin is an appropriate antibiotic for treating the infection. Hope that’s all that went wrong.

      • defendUSA says:

        WC-
        Thanks for the reply. Although I was ticked, in the end, it worked out fine. The son’s hand was markedly improved after 3 doses and is nearly healed as of today. As you mentioned, and the UC doc said, over a knuckle is bad. My son had a lot of pain over his 4th knuckle and the inflammation was spreading. But, alas, no worries. Recovery is going well. If you want I can send you before and after photos to post! :)

    • DensityDuck says:

      defend, I think that WC’s issue is not people with genuine possible-emergency situations (as with you and your son), but people who need a checkup or a prescription and go to the ED because there are truly no other facilities available to them.

      • defendUSA says:

        Exactly, DD. Maybe in my pissed state, I was not being rational! :)
        I used to work at the office where he is seen and I know they have the experience and the staff to treat my son, without question and so I posed to WC my question. In the end, all good!

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