When I wanted to get my teeth straightened the first doctor suggested pulling two teeth to make room. I walked out quickly. The second doctor confirmed the suspicion that this would have been completely unnecessary.
Why do patients leave against medical advice?
71–80 of 85 posts
Re: Why do patients leave against medical advice?
#72My dad had a heart-related scare, but we left the hospital after waiting 10 hours and not being seen (we were checked in an triaged, but that was it). Thank goodness I had prepared multiple meals + brought water but we did not expect that long of a wait, especially for something heart related. After all that time, it just felt less risky to go home and get some baby aspirin. They made us sign a waiver as we left.
> They made us sign a waiver as we left. Could you have refused?
Maybe? We were tired and just wanted to go so we didn't fight them on it.
Re: Why do patients leave against medical advice?
#73Earlier quoted context omitted.
Bankruptcy may very well do greater collective harm. Pretty horrifying to even have to weigh that variable.
As much as bankruptcy is horrible, it’s does not compare to the immediate harm of a disseminated MRSA infection. Let’s not be hyperbolic.
I would rather die than lose all my retirement savings and be forced to find a job in my 60s or 70s. No hyperbole at all.
Re: Why do patients leave against medical advice?
#74Earlier quoted context omitted.
GP could be referring to treatment being covered under the prior year deductible or max out of pocket. I have a friend who was hospitalized on December 30th and released on January 2nd. And that's how they hit their max out of pocket two times over the course of 4 days. It's an awful edge case. If they'd gotten terrible vertigo a couple days earlier or later, it would have cost them half as much.
doing this on an annual basis is such an obviously inefficient system (on both sides) that you'd think somebody would've developed a basic mathematical approach by now to disrupt the market. but of course in practice, most US healthcare consumers don't really have an actual choice about who they buy their healthcare from.
Annual basis for what is a lifetime time frame is one of those things that's bonkers the harder you think about it.
I knew a guy. In 2008 his wife's company went under. So lost the health insurance she'd had for 15 years. No COBRA and in 2008 no ACA either. Her gall bladder got infected and they had to put a second mortgage on their house. Both of them had been paying for insurance for 25 years at that point.
Me I didn't have health insurance between 18 and 40 when I started working for a big corp. Two years later racked up $50k in medical bills. Insurance paid almost all of it.
Crazy.
Re: Why do patients leave against medical advice?
#75I've witnessed several people AMA from hospitals. All of them were not being treated well for pain and even in cases where there were calls for psych staff to help - there was imo below minimal mental / emotional support given. In a couple of the cases the people were able to find better pain medicine on the street faster than they could even get a doctor to answer a nurses call to deny - and being able to find just…
I’m an anecdote, but I deal with chronic pain that is thankfully well-managed at the moment. When it wasn’t as well-managed my experience was that apathy among medical professionals was the norm and compassion was the exception. I’ve had particularly bad experiences in the ER and I’m reluctant to even go there anymore. There’s a whole performative thing you have to do at the ER to “demonstrate” that you’re not a drug…
>I don’t know what’s wrong with the medical system that has created such apathy toward pain
I think it's that they are harassed 24-7 by addicts seeking drugs. A callous forms. If you are the legit rarity then so sorry.
It's a problem with government policy that demonizes addicts and makes drugs hard to get. It's a problem with a pharmaceutical industry that seems to be playing games with supply and manufacturing. It's a problem with a medical industry that maximizes profits by hiring the smallest medical staff possible and running them ragged.
It's a dog's dinner all around. In a better world we'd probably hang the bastards. But realistically, I guess what we need is more black-market drug manufacturers. Basement percocet labs. Backyard opium farms.
Re: Why do patients leave against medical advice?
#76I left on day 4 of 6 combatting a MRSA infection. I left on 12/31 because the hospital could not tell me if my current insurance (COBRA) would cover the bills for days 5/6. Absurd. Turns out I was right in my estimations that the course of IV would suffice and also that the remaining days would not be covered. I feel like I 'survived' the hospital system, not MRSA.
On a similar insurance related note... I needed an emergency appendectomy and was sent home in pain by non-medical staff. I had gone to an urgent care clinic with abdominal pain. They pressed on my abdomen to see where the pain was and told me to immediately go to the hospital down the street and there would be a CT scan order waiting. At the conclusion of the scan, I was told to go down the hall to the ER for emerge…
That's insane. Luckily in the US this can't happen (post 1986) as EDs cannot deny care to anyone under EMTALA.
Re: Why do patients leave against medical advice?
#77Earlier quoted context omitted.
On a similar insurance related note... I needed an emergency appendectomy and was sent home in pain by non-medical staff. I had gone to an urgent care clinic with abdominal pain. They pressed on my abdomen to see where the pain was and told me to immediately go to the hospital down the street and there would be a CT scan order waiting. At the conclusion of the scan, I was told to go down the hall to the ER for emerge…
That's insane. Luckily in the US this can't happen (post 1986) as EDs cannot deny care to anyone under EMTALA.
This was in San Francisco in 2016. Maybe it's not supposed to happen, but it can.
Re: Why do patients leave against medical advice?
#78Earlier quoted context omitted.
I’m an anecdote, but I deal with chronic pain that is thankfully well-managed at the moment. When it wasn’t as well-managed my experience was that apathy among medical professionals was the norm and compassion was the exception. I’ve had particularly bad experiences in the ER and I’m reluctant to even go there anymore. There’s a whole performative thing you have to do at the ER to “demonstrate” that you’re not a drug…
>I don’t know what’s wrong with the medical system that has created such apathy toward pain I think it's that they are harassed 24-7 by addicts seeking drugs. A callous forms. If you are the legit rarity then so sorry. It's a problem with government policy that demonizes addicts and makes drugs hard to get. It's a problem with a pharmaceutical industry that seems to be playing games with supply and manufacturing. It'…
"I think it's that they are harassed 24-7 by addicts seeking drugs." - I don't think this is an issue, or is very minor - although maybe it is different in different places?
Perhaps places like portland or frisco are different than around my neck of the woods or are outliers compared to the country as a whole (?) - happy to get actual data.. not sure why anyone would go through the torture of an ER visit for drugs as an addict when you could hold up a piece of trash cardboard for 30 minutes and get enough cash to buy any dope you want within a stones through of any street corner easily these days.
My thinking on this issue is that the 'war on drugs' has had many side effects that are worse than the cure, some thoughts:
Lawsuits that cost big money have been filed and succeeded against pharmacies, individual doctors, clinics, hospitals and such right? (this scares the shit out of the people in charge and makes them force underlings to virtually stop prescribing anything that could cost money via suits)
Criminal charges for all these (doctors, dentists, clinics, hospitals, etc) - and not just charges, but also investigations - harassing staff, demanding paperwork, under cover investigations trying to trick people into making mistakes - ending up on a 'list' - even if you are not doing anything wrong, certain numbers or algorithms from a pharmacy can trigger being looked at -
the threat of having your ability to write pain meds - this could make it so you don't can't do many higher dollar services (think dentist, surgeon) - makes people err on the side of less meds than you may need..
All these places seem to want to punt on the responsibility..
eg - go to ER with pain level 9 for tooth infection - they give you a tylenol tell you to follow up with a dentist or primary care doc -
This war has created situations where pharmacies are blocking meds to patients against doctor's written instructions, doctors worry what pharmacies will do - worry about dea will do - worry what investors will do - worry if they can keep a license to work, if they can stay out of jail, if they can pay student loans and home mortgages -
they worry about many things more than they care for the health and well being of the patient, your family member or whoever.
There is also a class war going on - from what I have seen it's what language a person uses at a ER / clinic / DR - as jnovek mentioned 'There’s a whole performative thing you have to do at the ER to “demonstrate” that you’re not a' - there is a quick breakdown in these situations where a DR or nurse takes offense to language or the patient does not know how to communicate pain and suffering in the flower-y language that doctors are used to -
There are more factors, surely I am not thinking of them all at during this 5 minute reply post.
The extreme torture I have recently witnessed when this type of thing occurred was quite disturbing.
Even if you don't pray, pray that you never end up in an American hospital with extreme pain that does not show up on their cat scans well. imho, ymmv.
Re: Why do patients leave against medical advice?
#79Earlier quoted context omitted.
On a similar insurance related note... I needed an emergency appendectomy and was sent home in pain by non-medical staff. I had gone to an urgent care clinic with abdominal pain. They pressed on my abdomen to see where the pain was and told me to immediately go to the hospital down the street and there would be a CT scan order waiting. At the conclusion of the scan, I was told to go down the hall to the ER for emerge…
That's insane. Luckily in the US this can't happen (post 1986) as EDs cannot deny care to anyone under EMTALA.
To Europeans, US is like the only place where this constantly happens.
Re: Why do patients leave against medical advice?
#80This paragraph caught my eye: > The financial burden is not imposed on the patient only; the healthcare system is also affected by the consequence of leaving against medical advice. Reports have shown that the cost of an average stay was USD 3716.00 for those patients who left as planned. However, patients who left against medical advice and were readmitted had an average bill of USD 10,761.56 for staying 4.7 days in…
> This makes me laugh. As if medical care in the USA isn't already ridiculously inflated. Honestly this is an area where I'd invite Elon Musk to come in and disrupt. In the same way that he disrupted space travel and electric vehicles in part by asking, "do we need to do everything in the expected high cost manner"? Question if you need certain things to be at certain medical grade for everything. I get that staff is…
Your prosthesis will be a wooden leg and treatment for pain will be some high-tech irrevestible lobotomy