Fun in the Emergency Room

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.

    31 thoughts on “Fun in the Emergency Room

    1. Jay Jardine says:

      Luckily, your American system is only 50% socialized. Although, I’d wager stitching up a finger is one of the few “low-tech” operations our StalinCare system can actually handle.

      In Canada, you’re literally better off going to the vet – at least there they allow you to pay for service.

    2. billy-jay says:

      Pretty.

    3. Micha Ghertner says:

      That’s what you get for sawing rabbets.

    4. John Lopez says:

      Doctors are often idiots.

      I recently went to an allergist to see about getting rid of hives. After the usual go-round, meds not working, he wanted to give me something that “should” fix me up, with the minor aside that people who took it for two years went blind. Or there’s this other one, but then I’d have to get my liver cored every three months to make sure it wasn’t killing me. The (cheap, well-known) alternative was dismissed as “too risky”.

      I mumbled something about liking to see just fine, thank-you-very-much, and left. I did a little research on the ‘net, and lo and behold the too risky alternative’s worst side affects were causing you to have a fat face (really), and irritability. I judged that irritability was actually everyone else’s side affect (the assholes!!) and that having a fat face that I could see was preferable to a skinny one I couldn’t. I also noted that this drug was sold sans prescription from various online pharmacies in countries that speak English and have cable TV.

      Armed with this information, I returned to the evil doctor and said “I want a presription for this, I read about it on-line, it’s safe as houses”. I won the stare-down, and he wrote me a decent supply of pills for much less than KewlAussiePharm.com would’ve charged. He knew I was pissed at that point and that I’d of just doctor-shopped until I found what I wanted, and he of course wanted to keep billing my insurance company, good and hard.

      And now I’m cured. Yay for me, or something.

    5. John Lopez says:

      You’re irritating me, Stedman.

    6. John Sabotta says:

      After the big build-up, that photo is pretty disappointing.

    7. lung says:

      hi lopez!

      also watch out for a condition called “lung face”. it is like having “fat face” except that your face becomes round and your eyes are painted-on dots. if you have “lung face” it means you are lung. therapy = 1 donut, applied often.

    8. Andy Stedman says:

      Sabotta: Yeah, it was a lot uglier before the stitches, and for a couple of days afterwards. Not particularly debilitating to me, as I’m right-handed, and even though I’m a computer jockey I’m not formally trained as a typist so I type pretty fast with random fingers. I’ve stopped doing sword for a few weeks and have limited my judo to teaching only until the scab heals.

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    10. Joshua Holmes says:

      I like to justify the occasional donut with the idea that it helps prevent lung face, although that gets me strange looks from acquaintances.

    11. In some areas, the safety at all costs crowd has even invaded the area of veterinary medicine. When we needed to buy lactated Ringer’s solution for our diabetic cat, we had to have the equivalent of a note from mommy before the medical supply house would sell it to us.

    12. Mo Sonnenwirth says:

      < >

      I work as an ER doc, so I had to comment on your “visit”. You have no idea of how much worse it gets from our side, but you’re correct, it’s worse all the time. New forms for us and especially the nurses to fill out, new rules and regs under the guise of protecting you from our mistakes (though I’m convinced we make more mistakes ’cause we have to pay that much more attention to the paperwork and other crap that, heaven forfend, we ain’t gonna spend a lot of time actually taking care of the patients!).
      I read an estimate that there is an hour’s worth of paperwork and clerical garbage for each hour of patient time in the ER. Seems a bit much.
      The instructions you recieved are an attempt to inform..which IS useful, because you would have no idea at the level of ignorance out in the public for the simplest self-care of anything. People bring kids in with scraped knees because they don’t know wound care. We get paper cuts. Moms who can’t bother with a dose of Tylenol for their feverish and miserable kids. Also, of course, it’s an attempt to fend off malpractice suits, lest we are blamed for not saying what to do, and since we can’t count on you to have any modicum of intelligence…hence the several nice printed pages.

      < >

      Partially correct. Understaffed is the norm. But…there is a reason for overcrowding and overutilization. One is the ignorance factor. People come in panic for anything, as I wrote above. Two, medical care in the ER is either free, if you have Medicaid, near-free if you have a low co-pay, free if you have no insurance but give false info. where to send the bill (happens). You’re only screwed if you have crappy insurance or none and you’re honest. This leads to people using the ER for all medical care…because it’s often nominally cheaper to come see us than to go to a doc’s office. And for sillier stuff.
      On the other hand, Medicaid folks sometimes really HAVE no place to go, because most private MD’s won’t touch Medicaid. So even the well-meaning and truly sick have no choice.
      Then too, docs in our area, when called by anyone for anything, tell ’em “go to the ER”, no matter how silly it is. This is because of lawsuit fear. If you give any advice, you might be liable. So its the path of least resistance…go to the ER. We have folks apologize to us all the time, who tried to see their doc but were shunted our way.

      Even well-staffed…there are days we are absolutely inundated. Add the fact that we actually do take care of a lot of really sick folks who DO need to be in the ER on top of the other crowd…and we have no clinic in the area, so it’s either a doc. office or us…and you have chronic overcrowding. And too, there are a lot of reasons in the ER we get backed up. Too much to go in to, but suffice it to say, it’s not always the ER worker who are at fault.

      Lastly…yeah, shunting you from room-to-room does give the illusion that you are making progress in your visit. And adminstrators (Pod People) are more worried about how “satisfied” you might be with your visit (we actually have surveys done)…was the staff nice to you? Did they smile? Did they turn down the covers of your gurney?! Did they rush to find you the remote to the TV in your room so you wouldn’t get restive waiting for us to finish working on our cardiac arrest victim though you are there for a pimple on your ass the past 6 months that you wanted checked out at 3 am and WILL complain if the wait is too long? (Happens. We’ve had people screaming at us because we’ve taken an old person with severe chest pain from the waiting room out-of-turn, ahead of the person with a sprained finger..and had the finger asswipe start screaming “I was here first!”. NOT an unusual scenario.)

      I am not exaggerating. More time is spent worrying about this nebulous “satisfaction” crap than is worrying about whether we medically do the correct thing. I don’t mean we don’t want to make people feel good and help ’em, and I work with some of the hardest working, caring nurses in the universe…but the silliness of the “score” surveying is depressing. I don’t know if that’s why they moved you around, but…I wouldn’t be shocked.

      I”m glad the doctor was decent.

      Medicine is a true mess. It can’t be fixed, because the only paradigm most people will work from is the non-free market one. Our local newspaper says that medicine is a failure of the “free market”, when of course, there is no such thing. I became interested in economics and politics partly because I knew how badly things had become…but I didn’t understand it. I still don’t have all the answers…but every day I work, I am reminded that I know what doesn’t work. And that’s what you noted at the beginning…the increasing bureacracy.

      Sorry I went off on a long tangent about this. It’s demoralizing. Anyone with good (and realistic) suggestions?

      Oh yeah, forgot too…docs are just as guilty…we let this happen, and part of the problem was that we wanted to protect our turf. There are nurses and others competent enough to sew you up…but licensing…you know, limiting who can do what to protect the consumer…and monopolize the business to keep up the incomes of those involved.

      I

    13. Andy Stedman says:

      Wow, thank you for your thorough and insightful comments, Dr. Mo. You know what’s sad? Almost any doctor I talk to about this topic sounds at least a little like you. I think a lot of people see it, they’re just not in a position to do anything about it. I can understand why you stay in despite it, too. You have so much invested in being a doctor, and if you leave the “system” you would have to start all over.

    14. John Lopez says:

      Doctor Mo brings perspective to the discussion.

      Could it have been that the bad Dr Pill-Pusher with his Littler And Littler Liver Pills was afraid of some sort of legal action? Irritated folks with fat faces muttering ‘lawsuitlawsuitlawsuit’, staring through the corner windows with their goblin eyes and tapping, tapping on the glass with dirty cracked nails. Packs of lawyers baying and scratching at the doorsill of your miserable strip-mall medical office. The bland smiling faces of the DrugCorp reps, passing out samples of the latest blindness caplet, mentioning in passing how well the Senate majority leader gets along with their CEO and how the FDA is ‘looking into’ some of those old generic drugs.

      It’s plausible, and it fits with the perverse symmetry that government interference brings to the table.

    15. Andy Stedman says:

      My survey came in the mail today, as predicted by Dr. Mo (hopefully he doesn’t mind my calling him that.) I’m debating just writing the URL of this blog entry on it.

    16. Brian Macker says:

      I this a indication of high time preference on your part? I mean, is trying to grab the board immediately, and not waiting for it to fall and then investing the time and effort of bending over to get it, is that a indicator of high time preference? Just wondering. :)

      It made me think of the rape example Hoppe gave also. Is the commission of rape really indicative of high time preference. After all most girls aren’t going to give it up just for a couple dinners. What I mean in the case of rape it isn’t a matter of have it now by force, or later with addtional investment. I thought that was a bizzare interpretation. I always had interpreted rapists as people who were taking something they would never get in the first place no matter how hard they strived. I have the same opinion of robbers. They often rob what they never would have ever had the possiblity of getting no matter how hard they tried, given their natural talents. For most people having a million dollars is not a matter of waiting.

      In fact I wonder if a criminal would get indignant at the idea that he could have had something if he had only the patience to have waited. After all some criminals spend quite a bit of time planning their crimes. Of course there are stupid criminals that don’t plan well.

      Perhaps, low time preference correlates better to stupidity than criminality. So we can say, “Damn it was low time preference of me to grab the board”.

      Hope you get better.

      BTW. I had a similar incident with a shovel last year. The shovel handle snapped and hit me in the eye because of my low time preference behavior.

    17. Mo Sonnenwirth says:

      < >

      I actually want out. It’s just not so easy, because I am encumbered with the mortgage, kids, wife, and as Zorba the Greek said “the whole catastrophe”!

      But there are serious problems for doctors. I probably will go on too long as I rant here, so please forgive me.

      First, let me just give an example of bureaucracy: From the Joint commission for Hospital Accredidation website, about abbreviations they are trying to get us not to use because supposedly, these kill thousands a year: < > They also had suggestions like “come up with a song” etc.

      I proposed, instead of Operation BANEM…Operation Forgive Us Clearly Klutzy Emergency Medicos”. You can write out the acronym.

      Go to the Joint commission website for a truly frightening web experience of bureaucatese run amok. Pod People are truly running the deal. http://www.jcaho.org Great ideas…who can argue with safety? But do their recommendations really save lives? Dunno. I can’ even read half of what they write, because it’s in an unknown variant language…approximates English, but…it ain’t quite that.

      Many don’t like what they see, but they also have NO CLUE about how markets work, no idea about economics or politics anymore than the rest of America has. Sometimes less, because they didn’t spend a lot of time taking econ. clases. Some I speak with would be just as happy if we socialized medicine completely! Few can deal with a paradigm of a true free market in medicine. They can’t see it, can’t imagine it. They have no understanding of what capitalism is about.

      Of course, even if they do understand the nature of free markets, that might scare ’em off more, because it would be a threat to their incomes. The sordid story of how the A.M.A. was able to get the “alternative” med schools closed to protect the allopathic docs is NOT a well known tale amongst phyisicians. Even now, they feel threatened by anyone who might invade their (our) turf and take over some of our functions. You mentioned you thought someone could be trained to suture as well as a physician. Some of that is debatable, but yes, some doctor functions are being taking over (though some should NOT be, either. I do think we have knowledge that is NOT so easily obtained, and there is STILL an ART to medicine that most don’t appreciate. I know the kinds of cases and decisions I deal with everyday are not always very clear cut, to say the least..even the decision on how to close a wound..dermabond (glue)…stitches, staples, steri-strips…how best to suture, what kind…and should I step aside and call in a plastic surgeon?) …but I’ve had literature from my state medical society saying I should join so they could further the fight against naturopaths etc. All in the interest, of course, of protecting the consumer from the quacks…but the reality is that they want to defend the economic turf from interlopers, from the threat of competition.

      I am not gonna tell you I want my salary to go down! I think I’m worth more than I’m paid (who doesn’t?!), but I recognize that the free market and the idea of true competition can be frightening to SOME physicians.

      On the other hand…we’re just plain frightened. We truly are powerless against the bureaucracy; If I don’t fill out my forms, I’m jobless. If docs don’t do things right in their offices, they can inadvertently run afoul of the Medicare billing procedures and make inadvertent errors that can even land ’em in jail, as some of the rules and regs put the tax code to shame!

      Remember, too, docs are not necessarily running the show anymore. We are not in charge of our own destiny. We work for hospitals…we are under the thumb of HMO’s and insurance companies…we’re not own our bosses. We can’t call the shots, and in that, we’re no different than any other employee…you follow the rules or else. If you take Medicare and/or Medicaid..you are already a govt. pseudo-employee, and are at the whim of their rules.

      So first there is ignorance, secondly there is fear and powerlessness…we let this just happen to us, slowly and over time…but too, it was partly in response to doctors taking advantage of the system…when Medicare essentially let us determine rates…docs would pick a number and see what they could get for, say, taking out a gallbladder. Then they would ratchet up the price. See what the “market” would yield. Then the Feds got wise, came up with billing codes and put themselves more in charge of fixing prices.

      What else? Docs don’t really understand how to even get political power. Believe it or not, most docs I know really DO give a damn about trying to take care of their patients and do a good job..and not only because the trial attorneys threaten us. And who has the time, like most working-class Americans, to go protest and try to do anything?

      As a related comment…how will ANYTHING get changed in this country, when the hoi polloi are brainwashed, deluded and coopted to do the bidding of the politicians, instead of the opposite way ’round….the middle class KNOWS it is being screwed, but they have just enough to make life pretty decent…a nice big-screen TV (on credit), a nice car (on credit), a decent house…and it’s really true! Life ain’t so bad…but freedom slowly ebbs away…but those who need to cry out…even when they DO realize what’s going on correctly…they are CAUGHT. They have jobs and they have those credit payments to make…and so they’re going to schlep to D.C. and march? Or take time to write to a congressperson?

      Ok, doctors are no better. Most of us are just trying to work…and…take care of people. In spite of the hideousness of the system. Yes, some doctors are greedy assholes and nasty characters. Gosh, we’re like…people…but sometimes, we also don’t deal well with the duress we’re put under to comply with the insane bureaucracy, and so don’t always act our best. I’ve seen good, kind, caring docs, whom I’ve known for years, become surly and snappish, and it’s often from the pressure of what’s been going on in our work.

      So…I don’t have answers either. I’m not brilliant enough. I do know that things continuously worsen. I believe we need to get rid of most of the bureaucracy, go back to treating patients as our main goal. But somehow…we have to somehow fight against this entire concept in America that healthcare if a free and unlimited “right”.

      And it’s not just Medicaid folks…it’s insured people too. If they run to ER’s for minor nonsense…it just causes rates to go up for the rest of us who DON”T run to the ER for nonsense. But how do we change that?

      HOw do doctors fight insurance companies, hospital administrators, trial attorneys and judges, bad judgement and non-compliance and asinine behavior from some patients and families (and most are nice, in truth, bell curve holds here), how do we fight the state government and then the Feds?

      Which brings me to my “it’s broke and can’t/won’t ever be fixed” pessimistic throw-in-the-towel summary: Everyone is guilty. Liberal do-gooder big govt. idiots, govern. officials of every stripe, sleazy lawyers (not all lawyers are sleazy, and sometimes docs really DO SCREW UP egregiously, but there are attorneys who have sullied their profession), Big Money Pharma (not always guilty of everything accused of, but not innocent either), Big Insurance (where do we even start there?), hospital adminstrators who just have no clue or don’t care about their workers, patients and families with unreasonable expectations about what we can do or not do (or won’t take responsiblity, heaven forfend, for any of their own actions), and doctors who screwed over the system and plundered it, leaving us with a mess as well as doctors who want to protect what little power we have, plus our incomes…who’s NOT guilty?

      The ONLY hope is to somehow get this out of the hands of the bureaucrats. I’m not sure the free market can cure every business ill, especially the medical system, but what we have now is immoral and unworkable..and the solution is to NOt turn to more government control.

      I forgot that one other item about doctors. As with any other group of individuals…we will give up freedom for security. I think that’s still the central problem of politics and economics. People will almost, as a group, trade off even the ILLUSION of security and give up their freedoms. And that’s what the doctors have done, whether we realized it or not.

      I love that the survey came! I actually think it’s fine to query folks for certain reasons…for a genuine desire to improve services…to get ideas, suggestions…but IF its used for statistical nonsense…how valid can it really be?

      Here’s where it becomes crazy: How do you compare a hospital with say, a resturant? At a resturant, if someone likes it…they keep coming. They spread the word. They don’t have to, of course, keep going there, but only will if there is superior service and food. The resturant will either sink or swim depending on that. They won’t get government funds to keep going to provide “services” to anyone…there are other resturants, usually, nearby enough, so they HAVE to please or they are OUT OF BUSINESS.

      You cut your finger. You probably drove to the closest hospital…or if the closest wasn’t the best, you went to another close-by one. Or, you went where your doctor that was on your insurance plan was, or where your insurance plan would cover your visit was. Then…your visit was…good or bad compared to what? How many times had you been in an ER? With that particular problem, with that particular doctor taking care of you? Was it busy that night? Was it in the middle of flu season? Was it at 4:30 in the morning, when people even used to the overnight shift are not at their bounciest?

      Did you demand things be done a certain way? In a nice tone? Did you ask for loads of narcotics? Did you ask to get seen before the heart attack victim? Can you judge the quality of the medical decision making? (Maybe on a finger cut…but how about if you had abdominal pain…would you know what was the right test(s) to order?

      I”m not saying a survy can’t be helpful. But the variables are different and much more complex than at the resturant. And, the resturant can keep score easier. If business grows…do you really need a survey to tell you if it’s good or bad? But a hospital…and what if that survey is being used to dole out adminstrative bonuses? WHa….? And…you get the idea. The whole thing is stupid.

      Most of us who work in hospitals CARE about “satisfying” our patients, as best we feasibly can. WE don’t care about surveys. We care about doing what’s right, and that’s the medical care of the patient, and yes, combined with some good, common decency towards another human being. But our nurses had to endure a 70 minute video of how to smile and be personable. And that’s wha medicine is down to. Geisha nurses. Wal-Mart greeters. Surveys. How may we serve you today?

      And if we ARE surly jerks (a common complaint, and not always unfounded)? Maybe it’s because of how unreasonable the entire “system” has become.

      And Andy, I don’t at all mind being Dr. Mo!

    18. Tom Summer says:

      Mr Lopez

      Your comment that “doctors are often idiots” is particularly amusing when you claim to have learned more by searching the internet – such a reliable source of information – and come up with information you were convinced was right. I have to infer that you bullied the doctor into giving you steriods for hives. I would take a closer look at the list of side effects – asepic necrosis of the hips, death from sepsis, psychosis – and realize that maybe he was simply trying to use the least risky medicine.

      But I’m sure 30 minutes surfing the net taught you more than he knows. After all, he is an idiot who is only interested in your insurance plan.

    19. John Lopez says:

      Tom, it might very well be that you are perfectly correct and that I’m totally wrong. Of course, the doctor in question could have rebutted me as you did instead of mentioning a worst-case of “adrenal failure after 6 months of continuous use” as he did, also.

      Odd that he didn’t, perhaps he treasures the vision of me, hips rotted away, screaming for the demons in the floor to give me back my soul. Or maybe he just didn’t think of it. Or maybe the psychosis is preventing me from remembering.

      In any case, I do actually respect expert opinion (you’ll note that I went to a doctor), but I’m not going to surrender my judgement to someone else solely based on their expertise.

      Come to think of it, the doctor in question is the one who told me to research the blindness caplet on the Internet. So he’s the expert, but he referred me to “such a reliable source of information”? Either he’s worthy of the same sneer-off that you give my judgement, or your sarcastic insinuations are off-base.

    20. David R says:

      I too am an ER physician and would like to address the question, “do you really need to be a doctor to sew up that cut?”

      No, probably not your cut, but there are plenty of cuts that appear like yours that might actually be more complicated and need to be managed differently. An experienced doctor is your best chance to get proper care.

      In the finger and hand (and foot), tendon injuries can lurk below the surface, may be not diagnosed and have a bad outcome for that reason.

      In any wound, foreign bodies may be present and may be missed unless sought for.

      Additionally, depending on the mechanism of injury or in case of delay to treatment past a certain number of hours, infection risks may be high and the wound should be left to heal without stitches.

      Wounds, depending on their anatomic region, may have many other special considerations when repairing.

      Is it possible to train someone who is not a doctor to close wounds? Yes. In ERs that are busy, nurse practioners or PA’s can be hired to do the job. But the amount of class room and on the job training in wound management for these providers is usually a fraction of that which certifed emergency physicians receive. Given the different factors that can complicate wound management, it is still probably safest to have the doctor supervise.

    21. Dr. Andy says:

      I am not so sure I agree with the restaraunt analogy. McDonalds aims to serve all-comers, but at better restaraunts you better have reservatons or you are out of luck.

      More response at http://doctorandy.blogspot.com/2005/03/my-health-care-is-killing-me.html

      Dr. Andy

    22. Andy Stedman says:

      But what kind of “restaurant” is my local emergency room supposed to be?

      It’s not like I tried to drop by the Mayo Clinic.

    23. GruntDoc says:

      “Fun in the Emergency Room” by a patient
      No Treason » Fun in the Emergency RoomI 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 open…

    24. WHY NOT make a reservation? (re: the restaurant analogy)

      In this case, the patient would have been better off either:
      (1) calling about his accident and getting an assigned time to come to the ER, or:
      (2) going to the ER for triage and being told qpproximately what time he would be treated.

      I’d also like ERs to have comprehensive online scheduling. In this case it would have been better to take a fifty minute car ride to a different ER with a smaller backlog, if there was one.

      – The Precision Blogger
      http://precision-blogging.blogspot.com

    25. Bux says:

      Stedman. How’s Oprah? Did you speak to your Dad about stupid injuries? Screwdriver in the hand maybe?

      I am sick of the ER’s taking so long, and the expense, but let us look at the big picture. Some people can’t afford care as Dr.Mo said they have no choice. Some people can afford it and meet their Doc at the office after hours to avoid the ER completely. Some are average Joe’s who have insurance, go where they are told, and get the care they need. Sure Vets would cost less, I am sure their malpractice is lower don’t you think? If my child needs stitches I want (and hope I have had) the most skilled, qualified person doing the job. I don’t pretend to want a less qualified person working on me, but you ask for what you want.

      Lets also look at your restaurant analogy. People making min wage to serve you almost clean food at a time when they predict most people will be in, and will be in a good mood because they are not cooking and are out to have fun. To an ER which gets lulls and rushs nightly and attempts to staff for it and has to deal with people at their darkest scariest hour and tries to get them through the insurance process as quickly and efficiently as possible to give them care. Then the care they recieve is rushed at best so they can go on to another person who is just as scared and frustrated as you were. That doesn’t seem like a feasible analogy to me. Have you ever worked at a restaurant or hospital to make an experienced comment?

      I remember the last time I was in a hospital and lost someone I love, the hospital ended up writing off that person’s bill because they were so interested in the almighty dollar, you think, or because they were caring for the survivor?

      Sometimes things just are the way they are. If you want it to be different write to your congressman, senator, hell write to W, we are paying them to look out for us, utilize the tool.
      Just a thought…

    26. billy-jay says:

      New to this site, aren’t you, Bux?

    27. Stefan says:

      So it would seem.

    28. Andy Stedman says:

      I’m not sure who this “Bux” is. The screwdriver in the hand comment about my Dad is accurate, and the reference to losing a loved one and having the bill written off could be a reference to my brother-in-law, but the Oprah comment I have no clue about. Strange.

      If you care to identify yourself without posting it in a public forum, send me an email.

    29. John Lopez says:

      …but the Oprah comment I have no clue about.

      Oprah lives in a midwest “I” state, no?

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