The Finance Physician tells you how you can survive the ER

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I think that one of the things that might be important to cover in a site that is written by a newly minted physician is this article about how to survive the emergency room. My first month of hospital work which will start on the first of the coming month will be in the Pediatric emergency room.

From my experiences in the ER in places that include, Galveston, Houston, New Orleans, Minneapolis, Los Angeles, Philadelphia, and Hawaii, there are a few basic things that are common about all emergency rooms across the United States: They are PACKED. This is because as the years have passed, more people are going to the ER for common issues that can be seen by a physician. In general this would mean that most of these patients waiting in the ER Do NOT HAVE AN EMERGENCY. This is what pisses off a lot of health care providers in the ER. However, I can understand the situation because for a lot of people, the ER is the only place that they can get care. These include the people who don’t have health insurance and a lot of the illegal immigrants.

The most eye opening time for me in the Emergency Room was when I did my 2 week rotation at the Baylor Ben Taub emergency room in Houston. This ER is crazy. We had 12 hour shifts that seemed to last forever. Especially when those shifts were at night. The hospital ER was divided into 3 sections. The medicine ER which saw “medicine” patients or non surgical patients, the surgical ER which included the trauma patients and the urgent care patients which did not have an emergency really but needed to be seen.

I felt really bad for the “urgent care” patients because it would literally take some of them more than 12 hours wait to be seen by a medical student (me at the time) and another 5-6 hours before they get seen by a physician. People who went to the ER pretty much expected to stay there for a while and brought their camping gear.

Another big issue for people who visit the ER is the bill that they will recieve. If you have no insurance and are destitute, obviously you won’t be paying for anything. But for people like you and me, sometimes those bills linger and end up in collections because you can’t pay for it just yet and you are considered under the poverty line.

This is what consumer reports says about surviving the ER

1. Go- Quickly : if you think you’re having an emergency, experts say that you probably are. Go to the ER for severe physical trauma, sudden chest pain, serious blood loss, possible broken bone, sudden inability to use a limb, loss of vision, or “explosive” headache. The trick here is that in general, you will be able to go to the ER faster in an ambulance and you will be seen sooner if you come via ambulance. Also, I learned that if you say “chest pain” the ambulance has to come an pick you up.

2. Know the alternatives: if you have a cold, flu, minor aches, sprains, bruises, and prescription refills = DO NOT go to the ER. Go to an urgent care clinic. The ER sees patients based on how serious the injuries are and keep the really simple things that won’t kill you waiting forever (hey sometimes they hope you will just go home)

3. Don’t drive yourself: again, you will be seen sooner if you go via ambulance and also it is dangerous for you to drive yourself if you really need to go to the ER

4. Rally the Troops: this is “ICE” or in case of emergency in your cell phone or wallet. Another big thing that I feel would have help a lot of patients in the ER is if they had their medical history with them and list of contacts for family.

5. Follow up: this is critical, the ER docs will not know if you follow up. You are responsible for your own health and no one will be a better advocate than yourself.

6. Ask for an itemized bill: this is also important because you want to see what you are paying for.

NOTE: i recommend that you seek advice from your doctor for any health advice that you may need

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