An emergency physician goes to the ER, and is shocked at the care she receives
http://www.kevinmd.com/blog/2015/11/emergency-physician-goes-er-shocked-care-receives.html
I have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services.
Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a finger fracture that was threatening to derail a visit by my grandchild?
Well, not only was I billed for an exam that never occurred, but I was billed way too much — totally out of proportion to any value received. As a physician trained in emergency medicine, I received my board certification in 2001 from the American Board of Emergency Medicine. It’s pretty unlikely that I would feel the necessity to consult with a physician assistant. In fact, I said exactly that as I registered in the ED, hoping I would be able to obtain some relief from a digital block and perhaps, if appropriate, a reduction of the fracture. I was, at the very least, curious about the nature of the obvious fracture I had incurred. I asked to see a doctor.
I’ve already discussed this with peers. One did ask: “Why on earth would you go to the ED?” Well, frankly, I went on the advice of other colleagues, who suggested it was a good idea to determine the extent of the fracture — I didn’t get that x-ray vision with my medical school diploma — and some fractures truly need a hand surgeon. Again, a three-day weekend and the pain was significant; the last time I went to an ED was for a lumbar puncture, so it’s not my first response.
The PA failed to examine my hand. In my own residency, I would have been fired for failing to document a patient’s neurovascular status in the presence of a fracture — but I suspect he documented something and I’m going to get my records this week. I sat in the ED for 90 minutes, and no one bothered to ask me where my pain was on a scale of 1 to 10. The first sixty minutes, I would not have cared.
But after 90 minutes, my ibuprofen was wearing off, and it would have been nice to have someone ask — maybe a nurse? Even a ginger ale would have been welcome. As it ended up, I said: “I’ve been here 90 minutes, can I see a doctor? No one has even offered me a Tylenol for pain and I would like to see my x-rays.” The nurse or assistant, who knows, returned twenty minutes later with a prescription for 12 Norco and a poor reproduction of my x-rays on an 8 x 10 piece of copy paper.
For this, I received bills of approximately $1,500. The hospital customer service representative implied that if I had not been paying the bill personally, the charge would not have been disputed. Well, as a taxpayer, I think it’s time to start disputing these absurd charges. In this case, if any documentation of an examination was submitted, it must be fraudulent. The PA stuck his stethoscope on my chest, and I’m sure that increased the bill. As far as the finger exam, it didn’t happen; he never got within 2 feet of my finger. And I never got a reading of the x-ray, except for this: “It’s broken.” Really? I knew that before I got the x-ray. That’s why I came to the ED.
Unbelievably poor quality care, but it’s motivated me to keep a closer eye on health care costs, both personal and global. If we don’t pay attention, we have no one to blame but ourselves.
Karen Shackelford is an emergency physician.
Filed under: General Problems
off topic but where is J.P.?
I got email from JP yesterday.. He is having some health issues related to his post polio.. Knowing JP it will be just a bump in the road for him.
Precisely why never have gone to ANY ER for my multiple intractable issues (due mostly to incurable bone weakening disease) even when barfing uncontrollably on verge of blacking out due to lack of pain control–my appearance, BP, obvious condition(s) would still be perceived as a drug seeker I am certain. Plus it would more than likely not get me the needed pain relief & leave me in more pain from making the trip there & waiting in agony in uncomfortable surroundings.
I therefore am holding out til 911 which will be as I fall to floor unconscious my last act.
Is this the health system of the most progressive, democratic, wonderful country in the world as we have been led to believe???
NOT!!!
Another reason to film everything
This is why many pain patients will put their lives in danger rather than going to the ER because we get treated awful, especially when it comes to pain. No matter what the reason, most get treated as a drug seeker even if we don’t even ask for drugs! They look at your chart, see what you take & BOOM! You are no longer worth their time nor compassion as you are just another junkie looking for a fix!!
I have a new PCP . I am at Orange City VA Clinic. Satellite of The Orlando VA. I am in agony . I just went to a new Pain Management Doctor Dr Kuhn . I just went to blue button to read his report . He SERIOUSLY ,SERIOUSLY, SERIOUSLY undersrated my condition .understated my pain . Made observations on issues he never even examined on me physically. Chris Christie ( Ironically ) is currently on Greta Van Susteran . Discussing his Drug Control Proposition. Friggin Joke.
I need to get a second opinion . My new Dr . The third one at this clinic this year. Has cut all of my meds primarily pain meds . Based upon an electronic review of my medical records . From the pain Doc I mentioned . He is tapering me off . I have never been seen by either doctor over the last 2 1/2 months they have been reducing my medications .
I am a friggin 50 yr old man . Who lays in the bed rolling around groaning moaning hollaring out uncontrollably wth pain .primarily C.R.P.S II
and severly painfull peripheral neuropathy . .
Can they do this? Like I said I only finally just saw pain mngnt doc . On Tues. Just read his opinion . It is not at all a true representation . I really need a second opinion . I cant even tolerate getting to Doc .. before Tuesday Nov 3rd I havent even tried to get down the steps of my house. Since I had to give in to the agony and call 911 for an ambukence and four big paramedics to carry me out on a flat board . Due to a fall the day earlier June 8 Where I tore muscles in my back Compression fracture T-12 30 % loss of height.
Can I get a civillian second opiniin ? I have medicare to cover me if VA not available. Oh allow me to make very very clear . I am not a Combat Veteran . I am a Cold War Era Vet..
I am injured due to an accident at work .
Any advice ?
Thank You All.
May God Bless You .
T.B .
( My Fiancëe in the photo .)
That reminds me not once did I see the PA when I was in the ER with my kidney stone, not once was I examined by said PA. We did not see her until discharge. I will be checking that bill when it comes and if it show she examined me etc…. i will be making a visit to the hospital because as far as I am concerned she did nothing for me except order a CT, and a couple of pain meds and accuse me of being a drug seeker upon discharge. I do not think my insurance should pay her one dime for because she didnt do a damn thing. Her payment should go to the my ER nurses who came in frequently to make sure my pain was under control and treated me very well. They actually looked up my history in the electronic charting and knew I was telling the truth on my kidney stone history because they knew when I had had all my CTs and KUBs and had last seen my urologist.