Ranting

There was a story in the Palm Beach Post the other day about senior citizens buying a quick-access card for emergency medical care as part of their condo dues. http://www.palmbeachpost.com/localnews/content/local_news/epaper/2007/05/12/s1a_ER_CONDOS_0512.html

The article states that by showing the card on arrival to the emergency department, a patient will have his or her care expedited. This is the kind of idea that makes Emergency Physicians cringe. In the Emergency Department, no one is supposed to get special treatment. As patients come in, they are seen by a triage nurse and assigned a severity score. The sickest people go first. As they should. People who aren't having an emergency should go to their doctors' offices. But they don't. I have been chewed out by someone with an ankle sprain for a delay in care that was due to another patient's life-threatening condition. I asked him if he would want his grandmother to wait if she were dying and he said, "She should, if I was here first!" Poor grandma.

The underlying problem seems to be the misuse of the Emergency Department for problems other than emergencies. Here are a few advertising slogans I have come up with for the ED:

The VIP Lounge- Are you too important to make an appointment? Come down to the hospital and throw your considerable weight around.

The My-Doctor-Won't-Refill-My-Percocet-Room- Is your doctor blaming YOU for your addiction to narcotics? Go to a doctor who doesn't know you! Then threaten a lawsuit!

Chez Chronic Condition- Are you sick of your chronic abdominal pain? Is a life of bad decisions catching up with you? Come to the ED and kvetch!

The Sick-to-death Room- Have you seen every specialist there is for your numb toe and everyone says you're fine? Do you KNOW you need an MRI but no one will order it? Come to the Emergency Department and use the secret passwords: "I just can't take it any more".