Hostages in the ER

In a reminder that an emergency room can be dangerous place, this story reveals how desperate some patients are to continue their prescription drug abuse:

A man apparently distraught at not being able to see a doctor immediately held two hostages for 20 minutes at Frisbie Memorial Hospital Wednesday. . .

"They were able to get a doctor to respond to the emergency room," Officer Mike Allen said. ...

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In our instant gratification culture, this is an inevitable trend. Fast-food style medicine. These so-called "Minute-clinics" are being placed in department stores for walk-in urgent-care visits, which also serves to drive traffic into these stores. I think the underlying problem of poor primary-care access is certainly contributing to the demand. People are growing tired of waiting several weeks for appointments, and endless hours in ...

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The final word on South Shore ER

Today the Massachusetts Department of Public Health came down with its decision on South Shore hospital, just south of Boston. I have written about the situation previously and followed up here.

The Department of Public Health report, released yesterday, ends review of a dozen complaints about the pace of care in South Shore's emergency room since last year. It found that emergency room staff at the ...

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A recent study suggests that a single IM dose of steroid is equivalent as an 8-day tapering course of oral steroid in the setting of relapse rates from acute asthma attacks:

Objective: To compare the efficacy of long-acting IM methylprednisolone to tapering oral methylprednisolone in adult asthmatic patients discharged from the emergency department (ED).

Methods: Randomized, double-blind, placebo-controlled trial of a single IM dose of 160 mg depot ...

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A new study was released saying that tests are delayed on the weekends versus the weekdays.

In the study, published in the August edition of the American Journal of Medicine, researchers analyzed six procedures commonly used in emergency situations:

Purpose
Many hospital departments tend to have lower staffing levels on weekends. We evaluated the use of selected urgent procedures for emergently hospitalized patients and measured the time ...

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Nothing like reading an article about my old training ground, Boston Medical Center. Having the state's busiest emergency room gave them incentive to decrease waiting times, especially in light of the recent stories about other ER's in the state. They brought in a management consultant, and instituted some radical ideas. So far, seems pretty successful.

A sign of things to come?

We have concierge practices, now people can pay extra for "priority access" at emergency rooms:

The 95-year-old financially ailing Southampton Hospital - the only serious medical emergency center on the South Fork - is offering a plan aimed at wealthy summer visitors whose primary doctors are back in Manhattan and out of reach, presumably along with the hospital's sense of propriety. For $6,000 per family, or $3,800 for individuals, ...

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Medpundit has commented on the ER (mis)use piece written earlier this week, emphasizing the convenience ("In fact, you don't even have to walk to your tests. You get rolled to them in a wheelchair or gurney." - how true). Perhaps people are willing to wait the 5-6 hours in exchange for a second opinion, or in some cases a specialist evaluation. Beats waiting months. ...

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As a follow-up to what I wrote last week on the ER stories near Boston comes this report. Most of it we know already, but it's nice to see some concrete data:

One-fifth of patients coming to the ED did not have conditions requiring emergency care, and another one-fifth had urgent conditions that could have been treated in a primary care setting, the report shows.

Uninsured ...

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As a follow-up to what was written here last month, the AMA chimes in with their opinion.

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