Monday, October 30, 2006
News flash: Most ER visits are non-emergent
What's more, the patients know it as well:Among patients who had recent visits to emergency departments, nearly half believed their health problems could have been handled in a doctor's office, the study said.The key lies in making primary care more attractive to help with access. But is there a will to do this?
Many of the patients said they did not have alternatives, such as same-day appointments with a primary care physician, or evening and weekend appointments; nurse advice lines; or urgent care clinics.
"The survey results validate that for many patients, there are few viable alternatives to the emergency department," said Maribeth Shannon, director of the foundation's hospitals and nursing home program.
Posted by Kevin |
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Comments:
I was in private practice and could see my own patients the same day and often new patients the same day. I did this for 5 years until I realized I was martyring myself.
More than 50% of the time new patients could not make it to the office in time to fill out 10 minutes of paperwork. The staff would be able to bring them back in time, but their sheets would be blank, and I would be forced to ask them questions they could have written down for me through a forced smile.
At least in my neighborhood, there are still new physicians that can see patients the same day. I can't quote any national data. I suspect a part of the problem is the sloth of people in general. It takes much less work to drive to the ER where you can lie flat on your back and have a tech fill out your new patient paperwork than sit down with a phone for an hour calling around for a new patient visit. Obviously, this only applies to patients with insurance (and those intelligent enough to realize that the copay of the ER is 10 times the copay of an office visit).
Its also funny to hear how the defects in primary care have caused the ER crisis. No one seems to ever blame the person who signed EMTALA laws into effect. No one blames the un-insured. (yes, you are to blame if you have a car, jewelry and a TV, but feel entitled to free health care!) And no one blames the ERs themselves for advertising. What is missed in these debates is that hospitals gain alot of business through the ER and build them as gateways into the hospital. They will complain about the crisis, but then spend exorbitant amounts on valet service and thousand dollar signage.
You can't have it both ways. You can't advertise the ERs on billboards and then hate the people who come in.
b
More than 50% of the time new patients could not make it to the office in time to fill out 10 minutes of paperwork. The staff would be able to bring them back in time, but their sheets would be blank, and I would be forced to ask them questions they could have written down for me through a forced smile.
At least in my neighborhood, there are still new physicians that can see patients the same day. I can't quote any national data. I suspect a part of the problem is the sloth of people in general. It takes much less work to drive to the ER where you can lie flat on your back and have a tech fill out your new patient paperwork than sit down with a phone for an hour calling around for a new patient visit. Obviously, this only applies to patients with insurance (and those intelligent enough to realize that the copay of the ER is 10 times the copay of an office visit).
Its also funny to hear how the defects in primary care have caused the ER crisis. No one seems to ever blame the person who signed EMTALA laws into effect. No one blames the un-insured. (yes, you are to blame if you have a car, jewelry and a TV, but feel entitled to free health care!) And no one blames the ERs themselves for advertising. What is missed in these debates is that hospitals gain alot of business through the ER and build them as gateways into the hospital. They will complain about the crisis, but then spend exorbitant amounts on valet service and thousand dollar signage.
You can't have it both ways. You can't advertise the ERs on billboards and then hate the people who come in.
b
# posted by 
: 10:17 PM
: 10:17 PM
Half the patients in the ER I see tell me they called their doctors office and were told to go "right to the ER" because the doc had no open appointments. I turn around and needlessly admit alot of these patients since I know they can't get followup, and to share my malpractice responsibility with the PCP. So they get to see their doctor as inpatients. Everyones happy except the poor taxpayers.
# posted by : 3:40 AM
: 3:40 AM
Yep. Thanks for asking. Got into a mid tier university program in the midwest. Very excited. I'm almost finished with the ASH hem review book. It cost $300, but I feel prepared for my first day and I'll get 50 CMEs out of it.
When I told my group I was leaving, the president said good luck, told me I'd need to pay my own tail ($22,000) and that I couldn't see anymore new patients. (there were other people in the area in our group who weren't seeing enough patients to support themselves and he wanted them to see the new patients since they were staying). I made the mistake of giving them a year's notice. Since my income was based only on commission and I paid my own overhead, I would be making less this last year than my student loan payments if I just saw my old patients. So I left and am working as a hospitalist this last year.
Thanks for asking. Did you get a slot? Am I replying to the same anonymous?
b
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When I told my group I was leaving, the president said good luck, told me I'd need to pay my own tail ($22,000) and that I couldn't see anymore new patients. (there were other people in the area in our group who weren't seeing enough patients to support themselves and he wanted them to see the new patients since they were staying). I made the mistake of giving them a year's notice. Since my income was based only on commission and I paid my own overhead, I would be making less this last year than my student loan payments if I just saw my old patients. So I left and am working as a hospitalist this last year.
Thanks for asking. Did you get a slot? Am I replying to the same anonymous?
b
# posted by : 5:08 PM
: 5:08 PM
