re: people come to the ER at 2 AM for the stupidest crap

How many times do you see this one?


Mother: "Oh he's been having a fever"
Dr: How high has it been?
Mother: "It was up to 102"
Dr: Did you give him any Tylenol
Mother: "No I brought him here"


I'm thankful I don't work in the peds ER. I hear enough stories as it is from my friends that do. And have seen enough the few times they float me down there.

I can remember years ago at OLOL I floated to peds ER and some lady brought her 10 year old son in at 2 am the night before school started. His complaint...itchy scalp. Asked the kid how long this has been going on...he tells me a couple years. Kid just didn't want to go to school and had freaking dandruff. I really wish they would enforce $10 copays for all the people with Medicaid/no-insurance that come in with stupid shite like that. My copay is $250...I don't go to the ER unless it's a true emergency.

Wow, I'd start by learning the difference between a deductible and a copay before you start blaming Obama.

Why is that funny? I think it's more sad than anything else. Infuriating too.

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Why is that funny? I think it's more sad than anything else. Infuriating too.

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Cause when you see stuff like that day in and day out....sometimes all you can do is just laugh at times. I'm sure he's saddened and infuriated by it at times as well. But working in the ER will make you cynical. You see lots of people that truly need care, and then you see those trying to scam the system.

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OLOL

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Your first mistake, its the new EKL. Never again will myself or any of my family step foot in that welfare shithole again.

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My copay is $250...I don't go to the ER unless it's a true emergency.

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Honestly, it can be hard for those not trained in medicine to tell. I never bitched out a parent for bringing in a sick kid. One with ringworm? Yes. Fever and ill? No. Had too many with seemingly routine infections end up with something really bad on further exam. Kids can be very easy or very tough. I always felt better laying eyes and hands on them. And trust your gut. If something isn't right, do more or at least keep and observe. I wish it was as easy as "Don't come to ER for non-emergent shite."

And with copays, you don't want them to be a deterrent for a true emergency. I would see any child for any complaint. Even just as a screening. Still my policy in my office. We don't turn away sick kids. Want to get your arse fired at my office? Let me catch you telling a parent we won't see their kid because insurance is inactive or they can't pay copay/deductible. The kids can't help it and just the right thing to do.

Adults on the other hand? It just depends. The thing about a small area is that we generally know who can pay and who cannot. Don't drive up in your brand new F250 with a fresh tan from the redneck Riviera in all your brand new affliction shite and oil field trash money paraphernalia and expect to be seen for free or not pay on your old bill you've run up.

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How about us residents who make $40k and have never heard of a 3 day work week? If you are surgery, I feel bad at times. On bad nights, we annoy the shite out of y'all.

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This. And frick surgery. Not the profession, the residency. After 2 months of it in med school, any illusions I had of being a surgeon disappeared. Holy shite, Getting up at 3:30 every am to pre-round. Work all day. Be home about 7:30-8:00 when not on call. I cannot imagine that shite for 6 years...just to be general surgery (this is after 4 years of med school for those that don't know). And if you wanna make real money, a 2-4 year + fellowship after that...or more. HELL NO!!!! I'm glad some do!!! And I think they deserve more money that some of the more specialized surgeons. It's a fricking farce that orthos and ophthalmologists make more than they do.

To the good general surgeons out there.

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Honestly, it can be hard for those not trained in medicine to tell

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You know what I mean though. I'm not talking about the parents concerned cause their child has a fever and nothing they are doing is making it go away. I would say they should certainly have their child seen in that case. I'm talking about the parents that bring their kid in for a fever, that they have done nothing for, and expect the ER to treat it with Tylenol...cause they don't want to spend money themselves on buying Tylenol. Why should they...when they have a Medicaid card that will pay for all of it for them? Or they want a prescription written for Tylenol so Medicaid can pay for it.


Hell I would have parents on the peds floor complaining of a headache and asking me for Tylenol. I would explain I can't legally give them anything cause they are not a patient. Some would try to hand me their Medicaid card as if that was all it took. I then told them they can either go downstairs to the ER and wait to be seen....or go down the street to the 7-11 and buy some.

The last pt I had the other night around 530 AM had a fever of 100.1F (not a fever).

Did you give anything?

No.

Any other symptoms?

No.

Temp on arrival was 97.9F.

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I refer people out to our clinics all the time for continuity of care, but they never go. They keep returning to the ER for what should be a clinic visit.

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This. Even with free care and free meds, they still will go to ER. Had one last year. Infant with pertussis. Made diagnosis tentatively...only after agreeing to see child who came in with another for scheduled visit. And of course we weren't PCP on Arkids, which means we wouldn't get paid our shitass $35, started antibiotics appropriately and sent swab for confirmation. It was positive. Called in meds for symptomatic household contacts...all 15. Baby not brought back in for recheck, but instead ends up at Children's ER with pneumonia/pertussis. Check with pharmacy, none of the meds were ever filled. So...what could've been fixed with a simple office visit and a tiny bit of compliance ended up with an ICU stay for infant for about 2 weeks, hospitalization for grandmother for pertussis (didn't get or take her meds cause of $3 copay) and multiple other family members with more visits and treatments. Not to mention a little epidemic at the school.

That's what cannot be fixed with any system. A large portion of our population is worthless, lazy and stupid. You cannot fixed those things. Even with FREE CARE and FREE MEDS for the kids. ZERO compliance.