Child mauled by a pit bull, but the ER sends the kid home

Trying to find ways to decompress its crowded emergency department, the University of Chicago is “re-directing” non-urgent cases to community centers or clinics.

However, as emergency physician Shadowfax notes, you better be careful who you turn away, because as this case shows, doing it poorly results in a public relations nightmare.

Will those on Medicaid, or without insurance, be preferentially “re-directed” to safety net hospitals? In this instance, the answer appears to be yes.

The child, whose only insurance was Medicaid, had a chuck of his lip torn from his face. Instead of immediate surgery, he was discharged on antibiotics and told to followup at another instituton in a week. Instead, his mother took him to another hospital an hour away, where he promptly underwent surgery.

What’s likely to happen is that Medicare will “use this as an opening to delve into the records of [the University of Chicago Medical Center] and find every single transfer and redirect and crucify the organization for this and possibly other transgressions.”

ERs are placed in a tough position. On one hand, there is no question they are overcrowded. But in trying to find ways to reduce wait times, there had better not be an impression of cherry-picking patients.