using the ER as your primary doctor

[flight-lp]

The Local Fire/Rescue department can refuse to take a patient because it is not a emergency if they wanted.

Care to elaborate? I'd be interested in knowing how they ascertain that a patient is or is not having a medical emergency.....................

[spenac]

What makes me angry with this situation is the females that are 19 wks pregnant and have not seen a OBGYN yet. In our ER, we do not see pts that are over 20wks with preggo related symptoms. They go to the birthing center.

We get lots that are full term with no medical care during the entire 9 months. Some of them have not even been told by family or friends what to expect. These are fun because when they are still 20 minutes apart and they say it hurts so bad and ask is this the worst. Me being the compassionate sort I am look at them and say with warmth and feeling you ain't felt nothing yet.

Take OB's out of the ER stats from my ambulance because they go to labor and delivery.

Of the rest of our transports, and remember we deny transport here, Still less than 3 of 10 truly need the ambulance or the emergency room. Most would be fine riding with family or friends to the clinic. So yes abuse is rampant even in rural America.

[Richard B the EMT]

The stock joke line is the patient who calls, saying they have heart trouble, and the ambulance crew finds her waiting at the curb with a packed bag that is heavier than the equipment the crew would normally carry in.

That, even though the patient may have a legitimate cardiac issue, to me, rates as system abuse. Until my local laws and protocols change, as well as the way the third party coverages currently work, nothing will be done. The crew will be tied up with the truly "non-emergent call," and our old buddy, John Q. Public, the taxpayer, ends up footing the bill.

[Dooger]

These are fun because when they are still 20 minutes apart and they say it hurts so bad and ask is this the worst. Me being the compassionate sort I am look at them and say with warmth and feeling you ain't felt nothing yet.

My favorites too! I had one a few months back... 19y/o her first term-pregnancy, labor pain 20 min apart etc, screaming in the rig because of the "pain". I casually asked her if she thought this was bad how was she was going to cope when the contractions started. Her eyes blasted wide open and she said "you mean it's going to get worse?" She dummied up in a hurry. I giggled.

[tinman694]

The stock joke line is the patient who calls, saying they have heart trouble, and the ambulance crew finds her waiting at the curb with a packed bag that is heavier than the equipment the crew would normally carry in.

That, even though the patient may have a legitimate cardiac issue, to me, rates as system abuse. Until my local laws and protocols change, as well as the way the third party coverages currently work, nothing will be done. The crew will be tied up with the truly "non-emergent call," and our old buddy, John Q. Public, the taxpayer, ends up footing the bill.

So Lets do what my wife started after one of those calls last Friday night at 2am--- Call the Boo Boo Taxi.

Something Rising on your Tucus? Call the Boo Boo

Headache and Stomach Cramps? Boo Boo is the Answer

Need a Ride home and no one will pick you up? The Boo Boo Will!

Have 5 new Cadillacs in the driveway, but nobody wants to go to see the doctor but you? The Boo Boo will get you there in style!

We will bill your medicare/medicaid but they probably won't pay.

Have a nice day!

[Just Plain Ruff]

Tinman, I believe that the type of call you were referring to is affectionately known as the "Samsonite Call"

[BEorP]

Socialized medicine is NOT the solution. Here in my town, the native people have free health care. They have a clinic that is open every day. Do you think for one minute that stops people from presenting at two in the morning with dental pain they have had for two weeks? Nope.

Very good point. Look at Toronto as another example of this. Sure, people may have trouble finding a family physician, but there are a ton of walk-in clinics. And all of these clinics are of course free. Does that stop them from calling an ambulance for a tooth ache or the flu? Not at all. They even need to pay for the ambulance (usually just $45 but sometimes $240) yet they keep calling.

[pyroknight]

I heard an interesting statistic from Dr. Sanjay Gupta this morning. In the USA a patient usually receives a cardiac catheterization in a matter of hours in an emergent situation. Elective catheterizations are usually scheduled within 24 hours. In Canada, the average wait for emergency cardiac catheterization is 6 days (that's AVERAGE) and the wait can be up to 60 days for an elective catheterization.

[tinman694]

YEA SOCIALIZED MEDICINE!!!!

Only thing I can say about SM is when I visited Italy earlier in the year and had to go to a Pronto Soccorso they did immediately treat my anaphaxis....that's a good thing......

Positive Sign of Samsonitis....or Incarsaritis!

[goofymedc8]

Little bit of a late reply...still new to this site and playing catch-up..

I work at an inner-city level I trauma center ER and boy this post hits home!! It is nothing for us to have every room full, the lobby bustin' at the seams and tempers running high and hot! I would daresay that 60% of our pt load is a steaming pile of crap! I have learned the fine art of sniffing out drug seekers. When we get peeps in complaining of abdominal pain, eating chips and drinking a soda, my tolerance and compassion drop through the floor. These are the peeps that scream the loudest about the wait! Nevermind the cardiac arrest that just arrived, the 17yo male in trauma arrest because he has a 2" knife wound to his left ventricle and the NP is doing internal cardiac massage as the trauma surgeon puts 7 staples into his heart to stop the bleeding, the little old lady who can't breathe; or the 40+ yo male having a HUGE inferior MI! The ones that scream the loudest understand the triage process, but don't care that there are squads lined up with the truly ill and injured people waiting for the drug seeker to vacate the room after they get the footies, the snack-pack, and the warmed blanket! Nor do they care when a person who is truly ill, walking through the doors, gets a room before them when they've waited for nearly 2 hrs! I remember telling one person that there are 8 other hospitals in the city who are just as full as we are...they were more than welcome to leave and go to one of them and wait for their "Perkies". One other pt, one of our frequent flyers, came in complaining of a variety of issues. Triage medic brought him back to a room. I politely asked him to hop into a gown. He grouched at me and asked me "what for". I told him he knew the drill, the doctor will need to examine him so the gown needed to be on him. I told him I would be back to start his IV and draw his blood work. Well he hates IVs in the first place and withing 10 minutes he eloped AMA and did not return. That just fried me when the room was needed for an AMI coming in by medic.

Sorry...Got on the soapbox again. I just wish there was a solution to this problem...before it drives every good medical professional from the ER.