I did a dumb thing the Saturday before last. While sawing a rabbet in the edge of a board, my table saw kicked the board back at me. As the result of my instant, unthinking attempt to catch the flying board, I opened my left index finger up, down to the bone.
I initially called to my lovely wife for help, but then decided that she probably didn’t really need to see it. I wrapped it in a towel and baggie, and, since it was past 8:30 at night and the Prompt Care was closed, drove myself to the emergency room.
I spent the next three hours recieving a total of 20 minutes of medical care, in three different rooms. I don’t fault the doctors, of course, and I’m happy to have their expertise, but the sheer institutionalism and bureaucratic mindlessness of it all is worse every time I end up in a hospital.
An employee taking my information insisted that my insurance card, issued me by the major employer in town, was not right, that they were now a different color and design. I called my wife on the cell phone, and she described having a card identical to mine. I finally stonewalled her into accepting it. I have since discovered that the employee was right. For some reason, I never got the latest card. Apparently that doesn’t matter, though, as my claim is apparently being processed properly.
I was in two examination rooms, two treatment rooms, and two waiting rooms. They seem to have mastered the idea that you have to at least move someone every twenty minutes so they feel like they’re progressing.
I got asked at least five times whether the accident happened at work. Apparenty this must be reported to the Appropriate Authorities.
I had to give them my medical history from memory, despite having used this hospital’s services several times. Apparently, “that information got lost when we changed computer systems.”
The only really competent employee was the young doctor who sewed my finger up. It took her about fifteen minutes to put in seven stitches. She did a nice job, asked the right questions, and was quite pleasant to be with, under the circumstances. If anything, they had an overqualified person doing this job. Do you need years of medical training to sew a finger?
The height of incompetence was the young man sent in to dress my finger when she was done. He wanted to put a “frog splint” (seen on desk in picture linked below) on the finger, with its foam touching the fresh injury, and just tape it on with no dressing whatsoever. I talked him into putting some gauze on it, since he had no idea what I meant when I asked for a non-stick dressing. When I changed the dressing two days later, I of course spent ten painful minutes cutting and picking bits of gauze out of the dried scab. In retrospect, I should have sent him away as soon as my incompetence alarm went off.
I had to wait half an hour for my discharge instructions. There were several pages of instructions on “caring for your laceration” with fill-in-the-blanks left blank. Change the dressing after ___ days. Have stitches removed after ___ days. Very useful.
Total cost, mostly paid by my employer, is $1085. This is after a 50% plan discount negotiated with the hospital. That’s a very, very high burdened rate for less than an hour’s use of the facility and staff, and is no doubt due mostly to the layers of regulations and cost of liability insurance, as well as their legal requirement to treat those who have no intention of paying.
Even sutures and sterile wound cleaning kits are labeled that they are only to be sold to licensed physicians. That is, of course, to keep me safe.
Of course, I can only guess how this experience would have been different in a free market for health care, but I can make educated guesses based on industries that are similar in some way but are less regulated.
Restaurants and tire stores, like emergency rooms, never really know how much business to expect. However, it is unusual to have to wait hours for a meal or new tires, whereas in emergency rooms it seems to be the norm to wait hours for treatment. They’re not full, either, they’re just woefully understaffed.
A veterinarian has approximately the same amount of training as a physician (arguably more) at similar cost, yet a similar injury would have cost maybe a couple of hundred dollars to have treated on my dog–even at the after hours animal emergency clinic.
On the subject of veterinarians, many seem able to afford separate waiting rooms for dogs, cats, and others, yet I had to share waiting rooms with people with whooping cough, pink eye, and strep throat, all lovely contagious diseases I might want to share with my family.
Now, for the morbidly curious, click here to see the results. This picture was taken after about one week.