What's up with the overuse of "Urgent Care" and the "ER" nowadays?!

[m_ridgeway]

i work 6-7 days and 12+ hrs a day when im working, and usually at least 500 miles from home, so almost all of my visits are to urgent/er care. i see my dentist and my primary when im home if im sick and to renew my asthma scripts. other than that i dont go and in the last 5+ years ive been traveling, ive prob been to the er maybe 3 times.

my wife and son go a little more often but for the most part they will wait out the dr and my wife works at the hospital so she can take herself in if someone cancels.

i see alot of people in the er's for a lot of stupid stuff, my mom manages an er and my wife works at another hospital in the pharm so i hear them complain all the time about it.

i dont get how this would raise a rate/premium though because the few diff providers ive had i always pay more for the urgent care vs dr office. shouldnt they just raise the cost of the visit to cover the deficit here, if there is one?

 

[III]

Pay a pmt or something...jeez, what's up with society today? No one understands payment plans anymore? There are times in life when that's an option if times are tight, and most offices work with you. ???

Which makes me remember the days of the layaway plan.

I remember going to the dept. store with my mom when I was younger all the time. She's go up to the window, right out a check or drop off some cash, and walk away with nothing. Little did I know at the time that the reward would surely come if you kept at it...not only in the fashion of the actual goods themselves, but not carrying a credit balance either. I think today's society would laugh at that concept...probably why you don't see it around anymore. I heard Wal-Mart was trying to bring it back though. I wish them luck with that with today's mentality.

 

[S4L]

Interesting thread... I'll break this up a little bit

1.) From what I can tell now, it is largely a cultural thing that you go to the ER, well, whenever. Parents bring their children, those children grow up and follow their parent's guidance. It is not uncommon for a mother to bring herself in for shoulder pain x 2 days without injury, her 7 year old daughter for fever x 24 hours, and her son for unknown finger injury ("I don't know what happen, he just complains it hurts."). Some people really don't seem to understand that the ER is for emergencies and it is quite frustrating.

- On a side note, I see quite a few children that come in because the parents want a second opinion. I mean, quite a few, that come into the ER the very same night that they seen their pediatrician.

2.) By in large, most ER visits do not need to be ER visits. ER visits run the gamut - From death, gun shot, stabbing, disembowelment, to back pain x 2 months, constipation, one episode vomiting after drinking tequila, pink eye - you name it, it has probably been seen in an ER somewhere.
- Most of these visits aren't really by someone that has a legitimate concern for their immediate health. What I mean by this is, they aren't emergent visits, they are doctor visits. The ER is the EASIEST AVENUE TO HEALTHCARE, including to quite a few - free healthcare. Lets look at what makes the ER so appealing:
- Little wait at the right time. Our doctors and NP's/PA's are pressured to greet a patient within twenty minutes of arrival. We are also pressured to fill EVERY BED. This includes our Trauma bays that we would LIKE to keep open in case of well... Trauma or some other life threatening emergency. Think about this when you have to wait for three hours in an ER....
- Most blood tests are immediate, there is very little waiting and it is drawn on site.
- Instant radiological studies on site and read immediately.
- Immediate relief in symptoms - no need for you to fill a prescription (you can get the prescription filled after we treat you immediately). According to congress - patients have a bill of rights that includes being free of pain/misery. This bill makes sense right? Well.... That's a whole can of worms.

To a lot of people in our society - the ER is invariably the Wal Mart of the medical world.


3.) You guys need to come out from under your tinfoil hats. The swine flu and other potentially deadly viruses do need to be regarded with caution. During the swine flu epidemic - our ER, which seen on average maybe 220 people a day was seeing 330 a day. Many YOUNGER people were becoming quite ill with the swine flu with superimposing infections like Pneumonia. Not to mention, in 1918 a flu epidemic killed more people than the entirety of WWI (Over 50 million people). The swine flu, avian flu, SARS, and lyme disease are nothing to be scoffed at. Some of the sequelae from these diseases are enough to warrant you stay away from them. Simple Strep throat can, in a small percentage of cases, turn into Rheumatic heart disease.

4.) On a lighter note, there are people that abuse ER's and "doctor shop" for narcotic pain medication. Thankfully there is a system that is now being used, at least in Virginia, that allows physicians to pull up this information.


One additional addendum: It will never cease to amaze me how many people want a fix RIGHT NOW. So many people do not understand that there are no quick fixes in medicine. The body takes time to heal. I've actually seen a doctor argue with a patient because the patient wanted an antibiotic for his respiratory infection and the doctor wasn't going to give it to him because his infection was deemed viral (as most in this case are). The sad part is, not many doctors will take up this argument and will simply give the patient what they want. Often times, I feel medicine isn't about giving the patient what they need, it is simply giving them what they want. That trend in itself is something new to me.

 

[VaBusa]

i work 6-7 days and 12+ hrs a day when im working, and usually at least 500 miles from home, so almost all of my visits are to urgent/er care. i see my dentist and my primary when im home if im sick and to renew my asthma scripts. other than that i dont go and in the last 5+ years ive been traveling, ive prob been to the er maybe 3 times.

my wife and son go a little more often but for the most part they will wait out the dr and my wife works at the hospital so she can take herself in if someone cancels.

i see alot of people in the er's for a lot of stupid stuff, my mom manages an er and my wife works at another hospital in the pharm so i hear them complain all the time about it.

i dont get how this would raise a rate/premium though because the few diff providers ive had i always pay more for the urgent care vs dr office. shouldnt they just raise the cost of the visit to cover the deficit here, if there is one?

Your situation sounds like it warrants it, so understood...

Rates would have to go up if most are choosing to head to the ER or urgent care for runny noses and the flu over the regular doc. The overhead for those places, those docs, is just higher. Your bill for a trip to the ER is higher, hence even with insurance, someone's going to foot that bill eventually. I'd much rather know the more "trivial" illnesses are being tended to by regular doc visits than the ER visits. Just seems to me that far too many are abusing the system anymore, out of what they feel is convenience I guess...

We all eventually pay for these bad decisions...we pay for all that never pay, we pay for those that don't feel like paying in full, that don't carry insurance, that don't feel like going to the regular doc, etc...how could we not?

 

[VaBusa]

3.) You guys need to come out from under your tinfoil hats. The swine flu and other potentially deadly viruses do need to be regarded with caution. During the swine flu epidemic - our ER, which seen on average maybe 220 people a day was seeing 330 a day. Many YOUNGER people were becoming quite ill with the swine flu with superimposing infections like Pneumonia. Not to mention, in 1918 a flu epidemic killed more people than the entirety of WWI (Over 50 million people). The swine flu, avian flu, SARS, and lyme disease are nothing to be scoffed at. Some of the sequelae from these diseases are enough to warrant you stay away from them. Simple Strep throat can, in a small percentage of cases, turn into Rheumatic heart disease.

Not to dismiss any of what you said (and I don't have my tinfoil hat on today LOL), but you have to admit, seeing all you see, that as soon as the news of all the various "breakouts" hit mainstream media, you do see an HUGE increase in people flooding the ER thinking they have everything going around when in fact, they don't. What kills me is that at the first sign of a sniffle, people are willing to expose themselves to everything thriving in an ER waiting room, likely LEAVING with more than they'd ever bargained for. Why not wait a day or two, three? If you're not suffering from incredibly painful side effects or a really high fever, why rush yourself and risk exposure to what is out there? That's the part that I'm so sick of having to deal with when it comes to my ex and our two sons. He wants to drag them to the ER and urgent care constantly, and I say "no", they stay home a day or two, fever breaks, they're good to go. I'm a smart person; if the symptoms get worse, then I would certainly take them to the doctor for advice and further diagnosis, but why risk more exposure to viral infection?? The ER when you're already compromised is the last place I want to be...unless my body is telling me "Get me to the ER!!" I'm not going...

 

[S4L]

Not to dismiss any of what you said (and I don't have my tinfoil hat on today LOL), but you have to admit, seeing all you see, that as soon as the news of all the various "breakouts" hit mainstream media, you do see an HUGE increase in people flooding the ER thinking they have everything going around when in fact, they don't. What kills me is that at the first sign of a sniffle, people are willing to expose themselves to everything thriving in an ER waiting room, likely LEAVING with more than they'd ever bargained for. Why not wait a day or two, three? If you're not suffering from incredibly painful side effects or a really high fever, why rush yourself and risk exposure to what is out there? That's the part that I'm so sick of having to deal with when it comes to my ex and our two sons. He wants to drag them to the ER and urgent care constantly, and I say "no", they stay home a day or two, fever breaks, they're good to go. I'm a smart person; if the symptoms get worse, then I would certainly take them to the doctor for advice and further diagnosis, but why risk more exposure to viral infection?? The ER when you're already compromised is the last place I want to be...unless my body is telling me "Get me to the ER!!" I'm not going...

I do agree with you. I was getting to the "Yut ugh" moment as well with all of the news coverage on the swine flu and the movies they created. Quite a few nurses, including myself, refused the swine flu vaccination that they tried to FORCE on us (not to mention when they attempted to give it to us, we all had already been exposed).

I am however being forcefully reprogrammed. While a large majority of the time people become sick with simple viral infections and for the most part most people recover just fine from many many infections, I am being reprogrammed to find the 0.0001%'ers that actually have some sort of life threatening illness. I just read something on pediatric infections that pretty much makes me want to never work with kids again. (I hate reading the "damned if you do, damned if you don't" educational articles).

There are a lot of articles coming out of Europe showing that antibiotics for most simple infections like uncomplicated sinus infections, ear infections, and upper respiratory infections do not need antibiotics and that antibiotics do not shorten the course of the illness. Meaning that antibiotics will not help you feel better any quicker than you already would have.

 

[skydivr]

I've got to tell you, I've had sinus infections so bad my teeth hurt, and the only thing that fixed them was antibiotics.....

 

[Big Bo]

Where I live, uninsured folks clog up the ER for the littlest thing. In Cali it is illegal to turn away those that do not have insurance. 6 hr waits are comon. 12 hr waits are not unheard of.

Only in AMERICA ???

 

[Schism]

around here, the indigent seem to flock to it the most like it's a fad.

 

[S4L]

Where I live, uninsured folks clog up the ER for the littlest thing. In Cali it is illegal to turn away those that do not have insurance. 6 hr waits are comon. 12 hr waits are not unheard of.

Only in AMERICA ???

It isn't just California, it is a federal law that prohibits an emergency room from turning away patients regardless of their ability to pay.

 

[MarkZ28]

I have worked in an ER and the majority of patients we got were frequent flyers, that to put it mildly, liked their pain meds. When doing their history and info they always seem to have just ran out of their pain medicines that day or the day before. Always had a bunch show up right before a holiday or before severe weather was going to hit.

 

[theskaz]

I believe (Imagine Larry the cable guy here)

that guns dont kill people, husban.......whoops got off track.

Last time I was in the ER, I caught a ride there in a meat wagon. There is a thread on it here.

I refuse to go to the hospital unless I think I could die. I also refuse to take medicine unless I cannot perform needed tasks without it. I believe that folks that go to the hospital for everything, develop weakened immune systems because they get the sniffles and get antibiotics and their own body was able to fight it off to begin with. its just stupid.

Now, if my wife says go, I go. She has this ability to know when there is something REALLY wrong... probably the mom thing starting to kick in...

 

[theskaz]

oh and in Cali, I cannot get an appt (with my PCM) in the same month as my call to schedule it. usually 3-4 weeks out.