Saturday, December 29, 2012
Many who are fortunate enough to have insurance find that accessing medical care even in the best of times is impossible. Why? Well shit happens and shit happens at any time any where. To today's Doctor, unless that happens during conventional business hours and can be schedule appropriately its a trip to the ER to get the care one needs.
In the every increasing mythology that comprises the American Unicorn storyteller there is the one that its the hideous poors and their lack of insurance flooding ER's causing the ever increasing rise in Medical costs and of course the subsequent hideous care that results.
Well I have long written that is not the case and in fact its mostly well insured who find themselves availing themselves of ER care as they can "afford" it and in turn need it. Those uninsured find themselves relegated to the second tier of ignored or substandard care at Hospitals designated as those accepting the "poors". In other words you are not insured you will be transferred or in turn receive a waiting number that is into the next century or higher costs for the same care that the "Richs" get. Separate and yes unequal. Modern medicine is a hierarchy in and of itself.
The article below demonstrates that if there are clinics and care available at "off hours" costs are lower and patient satisfaction higher. Go figure. I have also put a few readers comments that are also very telling about real people and their experiences in trying to get medical (for lack of a better word) "care. Note the one from a Doctor which is usual and expected - loss of income. God shut up already. I wish there was some pill or drug that big Pharma could invent to give Physicians for them to STFU about their loss of wages. We can only hope. Prayer seems to work today when it comes to finding medical help and at least its free.
The Gift of After Hours Medicine
By Ann Carrns
Published December 29 2012
A new study shows that people who have after-hours access to their doctor use the emergency room less.
Published online in the journal Health Affairs, the study found that one in five people who attempted after-hours contact with their primary care doctor reported it was “very difficult” or “somewhat difficult” to do so. But those who reported less difficulty contacting a doctor after hours, say on nights and weekends, had fewer emergency room visits than people who experienced more difficulty.\
I can relate at least one experience in which our pediatrician’s evening hours saved us an emergency room visit, after a mishap known in our family as the Fork Incident. It was one of those times when we really needed to see a doctor, in person, past regular business hours — not just talk to an on-call advice nurse.
We had moved to a new town and into a newly renovated home, complete with polished hardwood floors. One evening, my then 5-year-old daughter was helping me set the table, and she grabbed a handful of forks from the silverware drawer. She didn’t run. But somehow, in the few steps to the table, she slipped and fell. On her face. On the forks.
When she began howling, I took one look at the blood pouring from her face and felt my knees go weak. Fearing her eyeball was punctured, I yelled for my husband, who calmly removed her to the bathroom to assess the damage.
The utensils hadn’t, thankfully, hit her eye. But the tines of at least two forks did pierce the skin just above her eyebrow, which was rapidly swelling. We thought it should be looked at by a doctor, just in case.
A call to our new pediatrician revealed that the office had extended hours on some evenings, and we were told to bring her in. The doctor looked at the rows of tiny holes above my daughter’s eye. “What kind of a fork was it?” he marveled. “It was more than one!” I blurted, feeling ridiculous. Everyone knows not to let kids get their hands on scissors or knives. But, come on — forks?
She didn’t need stitches, and we went home to put ice on her forehead. The after-hours clinic had probably spared us two hours of waiting and a $100 co-payment at the emergency room.
The study found that among people with a regular primary care doctor, 40.2 percent reported that the doctor’s practice offered extended hours. One obstacle to the wider availability of the service, the study noted, is that doctors are “insufficiently compensated for working evenings and weekends.”
The study concludes that after-hours access by phone or e-mail, too, offers the potential to reduce rates of emergency room use. I’m glad, though, that our practice offered in-person visits.
Does your doctor offer a way for you to get in touch on evenings and weekends, or to receive care after hours?
More likely six hours in the emergency room, not two.
My internist cannot be contacted even during regular business hours. In fact, I cannot even contact his "receptionist". All I get is a recorded announcement claiming (falsely, based on what I have seen in the office) that she is assisting another patient, and inviting me to leave a message that she may, possibly, return that day or the next. The receptionist needs a receptionist.
I have been a PCP for over 20 years...in that time my salary has stagnated or decreased due to outdated reimbursements. So now you want me to extend hours? 20 years ago, when we were making money, all sorts of courtesies were offered...staying late, an occ. house visit, offering people treatment over the telephone, forgiving someones copays, etc.. I can't afford to do that now. If I put one suture in someones scalp, I make more money that speaking to them about their cholesterol for 45 minutes. If you cut me, do I not bleed?
a few months ago my eye was very swollen. i figured it was probably an allergic reaction and called my doctor on a Saturday to get a referral, hoping someone would be open. he told me to go to the emergency room for a department they had to treat non-emergencies. i saw a physicians assistant who simply looked at the eye and told me i was right. she then instructed me to go to the pharmacy and pick up an over the counter eye wash. that was it...oh, except for the $1,500 bill not covered by my insurance company. i looked up emergency room visit level 3 and did not recognize any of the services they provided as being done when i was there. when i discussed it with the hospital, suddenly it became code 1 for $600.
if you ask me, the medical system is pretty broken. i don't even know if i would be able to get medical treatment at all in an emergency. some real work needs to be done here...
I work as an NP in a primary care office. We are open late two nights a week. After hours and weekends and holidays, one of us is always on call and patients call our service, who relays the message to us and we call the patient back. Many times, patients just need a prescription renewal (like an asthma inhaler they cannot go without). Other times, we can give them advice over the phone or send them to the ER if we think the symptoms they describe merit an ER visit. We really do try to keep them out of the ER, though.