Comments on: News flash: Most ER visits are non-emergent http://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html Tue, 14 Feb 2012 21:39:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html#comment-68306 Anonymous Tue, 31 Oct 2006 22:08:00 +0000 http://clients.emmense.com/kevinmd/2006/10/news-flash-most-er-visits-are-non-emergent.html#comment-68306 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. <br/><br/>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. <br/><br/>Thanks for asking. Did you get a slot? Am I replying to the same anonymous?<br/>b 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

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html#comment-68292 Anonymous Tue, 31 Oct 2006 16:42:00 +0000 http://clients.emmense.com/kevinmd/2006/10/news-flash-most-er-visits-are-non-emergent.html#comment-68292 b:<br/>Ever get that h/o fellowship? b:
Ever get that h/o fellowship?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html#comment-68285 Anonymous Tue, 31 Oct 2006 08:40:00 +0000 http://clients.emmense.com/kevinmd/2006/10/news-flash-most-er-visits-are-non-emergent.html#comment-68285 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. 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.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html#comment-68278 Anonymous Tue, 31 Oct 2006 03:17:00 +0000 http://clients.emmense.com/kevinmd/2006/10/news-flash-most-er-visits-are-non-emergent.html#comment-68278 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. <br/><br/>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. <br/><br/>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). <br/><br/>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. <br/><br/>You can't have it both ways. You can't advertise the ERs on billboards and then hate the people who come in. <br/>b 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

]]> By: Fleahttp://www.kevinmd.com/blog/2006/10/news-flash-most-er-visits-are-non.html#comment-68268 Flea Mon, 30 Oct 2006 20:56:00 +0000 http://clients.emmense.com/kevinmd/2006/10/news-flash-most-er-visits-are-non-emergent.html#comment-68268 I'l be damned...<br/><br/>best,<br/><br/>Flea I’l be damned…

best,

Flea

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