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The ER has become a sanctuary for society’s unmet needs

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Re: The ER has become a sanctuary for society’s unmet needs

#31

Post by giraffe_lady »

lm28469 wrote: post #28
denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

I've always been told ER is for _emergencies_, I'd never go there for a 2nd degree burn or a small cut. Emergencies as in "if I don't go there _now_ I might suffer _grave_ long term consequences" not as in "ouchie it'll be painful until I get it looked at tomorrow"

The thing is the doctor you would get to look at it tomorrow can simply decline to, the ER can't.

Re: The ER has become a sanctuary for society’s unmet needs

#32

Post by thatcat »

yamtaddle wrote: post #26
denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

After recently paying a fuck-ton for some stitches at an ER for a case that was a little hairier than urgent cares were willing to take on, but not at all life threatening, but also not something that could wait for a regular doctor... yeah, I'm seriously considering learning to apply sutures and buying a kit or something. I hate having to do "go, or don't and just hope it's OK?" when the best choice is clearly to go…

A butterfly kit is a decent compromise that doesn't really require training. https://www.amazon.com/Sutures-Waterproof-Butterfly-Hospital...

Re: The ER has become a sanctuary for society’s unmet needs

#33

Post by pcwalton »

denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

> I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for.

In the US, this is what urgent care is for. If there's an urgent care clinic in the area, you should absolutely not go to the ER for that kind of stuff. The price of the ER reflects the fact that it's for major, life-threatening emergencies; if you go there for a cut requiring stitches, then you're not using the medical system efficiently, and that's why the costs are what they are.

Personally, I've found the urgent care clinic I've gone to to be a better experience than both the ER and my primary care physician. It's gotten me in and out with quick, high-quality care, and it's cheap.

Re: The ER has become a sanctuary for society’s unmet needs

#34

Post by yamtaddle »

thatfrenchguy wrote: post #27
User23 wrote: post #12

Earlier quoted context omitted.

Somebody has to pay for all the "free" care.

Hospitals in the US (just like a lot of other market participants) have no incentive to save money. This is what universal healthcare would give you: more money spent on care, less on bullshit. Obama famously said you couldn't do universal / single payer healthcare in the late 2000s because it would destroy too many jobs in billing.

The military is our blue-collar/lower-class jobs program.

Our healthcare system is our white-collar/middle-class jobs program.

Re: The ER has become a sanctuary for society’s unmet needs

#35

Post by lotsofpulp »

genderwhy wrote: post #4

When you don't spend the time and money on preventative care as a society, you end up spending much, much more on emergency care. I feel like this has been quantitatively demonstrated again and again, but it's somehow still a political football.

Because the “you” is not a single unit.

Due to freedom of movement around the US, population wide benefits such as healthcare, housing, and in some ways, education, require federal level solutions.

Otherwise, someone is going to end up being the sucker that foots the (giant) bill for everyone else.

On the federal level, there is quite a bit of gridlock, so what we have is an intractable problem at the non federal level where it is every man/neighborhood/city/county/state/hospital for themselves.

Re: The ER has become a sanctuary for society’s unmet needs

#36

Post by denimnerd42 »

lm28469 wrote: post #28
denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

I've always been told ER is for _emergencies_, I'd never go there for a 2nd degree burn or a small cut. Emergencies as in "if I don't go there _now_ I might suffer _grave_ long term consequences" not as in "ouchie it'll be painful until I get it looked at tomorrow"

Well we're not only talking about adults but also talking about children here. At 9pm you get a small AND deep cut requiring stitches. It won't stop bleeding if you take pressure off. what do you do? At 9pm your family member accidentally drops a kettle of of hot but not life threatening water on your child and they get a large blister on their chest, what do you do? These are probably not serious situations but the pediatrician will tell you to go to the ER even if you wait till the next morning.

Re: The ER has become a sanctuary for society’s unmet needs

#37

Post by ticviking »

notch656c wrote: post #21
genderwhy wrote: post #4

When you don't spend the time and money on preventative care as a society, you end up spending much, much more on emergency care. I feel like this has been quantitatively demonstrated again and again, but it's somehow still a political football.

Having worked in an ED I can tell you it's much more like "when you make ED the only place that can't turn away patients, patient goes there for everything including the common cold." It's not so much a minor thing turned into an emergency (that is a problem of course) but rather the patient has no other venue for minor needs without money or insurance.

This is the big thing.

If triage were able to turn away non-emergency cases legally it would gradually change, but for people with more time than money the ER basically ensures you'll be seen.

Re: The ER has become a sanctuary for society’s unmet needs

#38

Post by giraffe_lady »

maxsilver wrote: post #22
at_a_remove wrote: post #8

Earlier quoted context omitted.

I was just about to mention that. The vulnerability to this kind of exploitation takes a different from than the emergency room. The Internet, search engines, Google, and so on created a kind of identity crisis in the library world, partially stemming from the people who think that they're going to learn with any depth from a quick search, but also self-inflicted, "Who are we in a 'digital age'?" sort of wailing. And…

> Interesting, too, that one of the other big societal institutions open to all comers, the churches, have largely dwindled. Churches (at least in the US) haven't been open to all for many decades now, they're highly exclusive places. Yes, technically anyone can usually walk through the door on a Sunday morning for free, but other than that literal hour, Churches usually have a lot of restrictions before a person is…

That might be generally true, I don't have wide enough experience to say. But in the urban core of large cities, churches are frequently a resource for acute needs. When I was homeless I took refuge from bad weather in them, charged my phone, shaved in their bathrooms, etc. Shit one time I went in one to figure out the time and the priest walked me to CVS and replaced the battery in my watch.

Some or most of them probably do operate like you say but I don't think it's evenly distributed because I never ran into that in cities. Usually if they didn't want to provide services they were just closed except during worship hours. But evangelical megachurches are underrepresented in urban cores compared to their national presence, which may play a role in my experiences.

Re: The ER has become a sanctuary for society’s unmet needs

#39

Post by anigbrowl »

lm28469 wrote: post #28
denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

I've always been told ER is for _emergencies_, I'd never go there for a 2nd degree burn or a small cut. Emergencies as in "if I don't go there _now_ I might suffer _grave_ long term consequences" not as in "ouchie it'll be painful until I get it looked at tomorrow"

Except if you try to get medical treatment for a minor injury the response is often 'no go to the ER' because people want to avoid liability.

Re: The ER has become a sanctuary for society’s unmet needs

#40

Post by lm28469 »

giraffe_lady wrote: post #31
lm28469 wrote: post #28

Earlier quoted context omitted.

I've always been told ER is for _emergencies_, I'd never go there for a 2nd degree burn or a small cut. Emergencies as in "if I don't go there _now_ I might suffer _grave_ long term consequences" not as in "ouchie it'll be painful until I get it looked at tomorrow"

The thing is the doctor you would get to look at it tomorrow can simply decline to, the ER can't.

Exactly, and that's why when you go there you have to wait 8 hours because you have 38 non emergency scenarios before it's your turn.
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