For someone as introverted, sarcastic and disillusioned as I am, my level of empathy can be disturbing. I think that might actually be WHY I am all of those things. Defense mechanisms and all that.
Sometimes I have to take an internet holiday – either walk away from the web completely, or just hang out on Pinterest looking at pretty things, like DNA under a microscope and schools of illuminated jellyfish.
This article, that I just read on NPR pushed me to that point. It wasn’t so much the article as it was the comments.
If you don’t have time to read the article, it is about “Ted” who, despite having a regular doctor he sees each month, visits the ER 20 times in a year. The doctor writing the article discusses the pilot program at his institution that budgets for nurses to work on a more autonomous level with calls to high risk patients to deal with preventative measures, since the monthly visits with the doc are largely to put out “Ted’s” latest fire. The whole idea of the nurses program it to help cut down on some of the ER visits that use up valuable resources on situations that could be handled outside of that environment.
The article itself was brief, to the point and carried the suggestion that this may be an excellent way to mitigate some of the costs associated with the ER runs that could be handled another way.
But the comments. Oh! The comments. The myopic, shallow, heartless, ignorant, intolerant COMMENTS.
They must be mentally ill. It’s because they don’t have to worry about the financial repercussions. It’s because they need attention. Because, because, because.
I’ll go out on a limb here and say it’s because, like the penal system, our medical system is flat-out busted.
I have been, and know others that are frequent fliers in the ER. Not because we are mentally ill, not because we are crying out for attention, not due to lack of financial responsibility. Just because.
Because 4 times out of 5 when I call the doctor about symptoms my very healthy son displays that have me concerned, there are no openings. And because my doctor knows us, and knows I am not alarmist, when they have no openings that day, they advise me to go to the ER.
Because when you are poor and uninsured, a fall is something that is brushed off. But 8 hours later when the swelling reaches a horrifying point and the knee can’t even bear the weight of the sweatpants covering them, maybe something is actually broken in there.
Because if you miss any more work days on the precious job that keeps you hovering at just over 30 hours to keep from having to offer you benefits, you’ll be fired. And of course, your doctor clocks out before you do.
Because the insurance company gets what the insurance company wants, and it wants you to have a Re-Evaluation before you get any more refills on the rescue inhaler you’ve had since you were nine. And of course, the doctor has no openings today. Or any time over the next three weeks for that matter. So it’s off to the ER to give Blue Cross what they want. Because rescue inhaler.
Because sometimes, you have met the annual limits on regular care for a certain service, but if that service is part of an ER visit, then your insurance will pay for it.
A lot of these come down to doctor availability. There are too few clinics that work outside of the 9-5 scope – in my world, there are exactly none in a 30 mile radius.
And too many doctors are part of large medical groups, they’re all about the numbers, not the care. That’s not cynicism speaking, that is experience. I have worked in the healthcare field in various capacities for 15 years. There are incentives, bonuses, preferred provider status and other nifty little things that keep doctors working within a particular set of guidelines.
And those guidelines include treatment plans and next appointment scheduled. If my next appointment is in 2 weeks, fine, schedule it. But when the next time you need me is literally so far away that your scheduling program won’t let you advance that far – don’t bother. Call me with a reminder next year. That would take 5 minutes, total.
Instead, the receptionist will spend 5 minutes making the correct notes to schedule the appointment when the admin opens up the schedule that far out. Then, in a year, someone will call with a reminder anyway. But since a year has gone by, I have developed other plans. So I call to reschedule, get put on hold for 5 minutes to be told I can’t get in for another 3-5 weeks, spend 5 more minutes haggling with receptionist before accepting the appointment on my birthday.
I forget to clear my answering machine and I no show. Which costs me $40 that pisses me off mightily, and wastes a time slot that could have been given to someone who is going to end up going to the ER because the office had no time today.
STOP GIVING THE FUCKING MOUSE A COOKIE!!!
With very few exceptions, there is no cause for scheduling out past a 6-8 week window. And that is a conservative window. And if doctors weren’t so busy jamming people into their schedules a year in advance for preventative care, which usually amounts you, “How ya been?” I might actually be able to get in to see the doctor when I am sick.
I’m not knocking preventative medicine. I think it is a good thing. But I also firmly believe that having someone call once a year to schedule that visit would be as effective, if not more so than trying to book my life out a year in advance.
People that will go, will go. People that won’t, won’t. Having an appointment in advance won’t matter.
- The challenge of frequent fliers: 20 ER visits per year is progress (medcitynews.com)
- Didn’t get anywhere (daniellesdailylifeblog.wordpress.com)
- When To Visit An ER And When To Visit An Urgent Care Center (medicalhealthsolution.wordpress.com)