Wednesday, October 22, 2008

Doctor Bashing Alert


"Woman who waited 19 hours and never saw doc balks at bill". That was the front page headlines on the MSN website. The reality, however, is that story is about ER waiting times and not about evil doctors. To sum up, a woman broke her leg and it took hours before a nurse even assessed her. She was then triaged and placed in line to be seen but gave up after a total of 19 hours. A ridiculous wait for anyone. The problem, unfortunately, is that this is the reality at big inner city hospital ERs. They are overwhelmed. The woman left the ER and found out through her chiropractic school, where she attends, that her leg was broken. My hunch is that it must have been a fibula fracture for her to be walking but it is never explained in the piece. She later received a $162 bill for the "nurse's assessment" and refuses to pay. Let's break this down:
  1. ERs are overwhelmed so don't go there unless it is an emergency.
  2. The cost for an evaluation and treatment at any level in the ER is ridiculously high due to cost shifting.
  3. These long waits are due to the ER trying to stratify levels of emergencies. A fibula fracture, in which patients can walk on, will have to wait while gunshot victims are being immediately assessed.
  4. If the woman came to my office, as a family doctor, I could have seen her that day and gotten the x-ray quicker. The wet read would have been at my office later in the day and with a return phone call we would have mapped out a plan - all close to the same bill of $162 (including x-ray).
  5. Lastly, MSN was wrong in making the headline seem that some greedy doctor, who never saw the patient, sends her a bill anyway. This was about ERs and hospital bills and a patient who went to the wrong place. Stop bashing us!