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125 Comments
- qwickone, on 10/12/2007, -6/+86While I totally agree something needs to be done in this case/cases like this, ER staff is generally severely overworked, especially in a big city like Chicago. And if it was a county hospital, they probably DONT have the money (yes, there are people at the top whose wallets are getting fat, but the money isnt there at that level). People might appear to be standing around doing nothing, but they probably need a break or are going over charts (so it doesnt look like theyre busy) or reviewing test results. I've worked in a hospital before, there's not much down time in the ER. They just cut staff to skeleton levels when they know it'll be slower, so there is still the same amount of work to be done per person.
All that being said, this woman was OBVIOUSLY having a heart attack. Someone needs to lose their job. - Aesculapius, on 10/12/2007, -0/+63I am a doctor, and have worked in an ER....
1. ER's do not make a lot of money. Why? EMTALA. A good law that says no one can be refused treatment in an ER for any reason. Good law that has been abused. Many poor and uninsured people use the ER as their regular doctor with no intent or capability of paying. Because of this, there are fewer ERs open today than 10 years ago. Also, the amount of utilization is up.
2. The action of this ER is unexcusable. Chest pain is something that is "hard wired" into medical care in the ER setting. Should someone doing triage hear anything like "chest pain" from a patient, they are an automatic priority. Hospitals track things like door to ekg time, door to drug time and door to catheterization time. The current standard for time between showing up and getting to the cath lab is less than 90 minutes. We can even do that where I live in the country. Our door to cath time is around 70 minutes and that includes a chopper flight.
3. Doctors and nurses work their asses off. It's hard to make people understand this who aren't in the field, but when patients wait, it does NOT have to do with doctors and nurses wasting time. It's an overburdened system. - inactive, on 10/12/2007, -1/+52"keep your sorry ass alive when you need it"
That worked out well for the woman in the article. - qwickone, on 10/12/2007, -3/+33I'm not saying this to be an *****, but because most people dont know about this. For something like that you should go to Urgent Care, not the ER. You should pretty much only go to the ER if youre actually dying or think youre dying. I've only had to go to urgent care twice, but both times I was in front of the doctor in under 30 min.
- Aesculapius, on 10/12/2007, -1/+31There is a kernel of truth here.
There is an old saying in economics....
1. You can have it quickly
2. You can have it cheap
3. You can have it be high quality.
Pick 2.
The US system uses 1 and 3
The Canadian system uses 2 and 3
It's all in the priorities. - superal1394, on 10/12/2007, -1/+29"About time... the waits are horendous and both doctors and nurses are standing around not doing anything. If they need more people in the ER then the hospital should allocate more people. It's not like they don't have the money..."
Actually, most hospitals DON'T have the money. Most rich doctors don't work for the hospital, they work for a private practice or a partnership in an affluent area. The doctors that work in the ER do that because they love to, not for the money. The money in medicine is in the private practices and partnerships.
Just thought I should clear that up as the son of a doctor and volunteer at local hospitals. - masamunecyrus, on 10/12/2007, -3/+28They need to prioritize their ER patients. The guy with a broken hand? Yea, it sucks, but you can wait. The lady who's having shooting pains down her left arm? She needs to be seen right away -- even if it means kicking a guy with a broken leg out of a hospital room. If he's not an *****, he'll understand that a heart attack is more urgent than his broken leg, no matter how much it hurts.
- Pokez, on 10/12/2007, -22/+45Billyboobs, you OBVIOUSLY are not an MD or an RN,so i would like to kindly ask you to not blatantly bash these hardworking healthcare professionals that went to school for MANY years to keep your sorry ass alive when you are in need.
- benitojuarez, on 10/12/2007, -4/+21qwik this was in WAUKEGAN not chicago. They are two VERY different places.
- heavensblade23, on 10/12/2007, -1/+15By that logic we should never sue ANYONE for malpractice. Your logic is faulty.
- daldredge, on 10/12/2007, -3/+15@Pokez
I have been to the hospital with out insurance, they wanted thousands more from me then they would have received from an insurance company.
If hospitals gave those with out insurance the same rate they give insurance corps more people would be able to pay. I have been on both sides of the fence and it is crazy that a hospital will charge an insurance company 200 - 300 for a procedure they charge othres 1800-3200 for. - Dragular, on 10/12/2007, -3/+14***** all around, especially at the "county hospital" comment. I live in Smalltownonia, Alabama, and work at the local ER, and I guarantee you that on a PER CAPITA basis, we have at least double the amount of visits most large cities get. Why? Because there's no ***** clinics anywhere that will take uninsured patients, so we get stuck with the stragglers who have sore throats and the seekers coming in for pain medication. So of course the ER is full 24/7 with people claiming that their dying, and it's a bit hard to get to the genuine emergencies when they occur.
As for the racist comment up there by Skudge, I'd like to point out that with most of our uninsured and underinsured patients, hispanics typically pay their bill before they even leave the building, while most of our white trash patients will give us false addresses and say "Just send me a bill."
***** crackers! - BritOverseas, on 10/12/2007, -4/+15Whilst I agree with "some" of both sides of the stories here, I mean COME ON, you are ***** joking right?
4 times over the last few years both my Wife and Daughter have been to the ER and had surgery. My Wife for a tubal pregnancy and thyroid problem and my daughter for extreme vomiting and dehydration, twice.
Each and EVERY time it has cost us THOUSANDS and that is with insurance (albeit crap insurance). How can this be, greed, thats how.
The medical profession in the States has turned into one big money making factory, you only have to look at the gleaming new hospitals and medical building in Houston to see that. Marble and expensive offices everywhwere. You know who is paying for that, mugs like us.
My daughter was not even admitted!!!! $3000 for an ER doctor to look at her, some fluids and a VERY long 5 hour wait before that happened, ***** ridiculous.
Thats not to mention the actual birth of the 2 kids, the second one I paid for IN FULL (nearly $15K) as we had no insurance at the time. $1400 for an anastheaseologist???? He was there for 20 minutes, what is that $4200 an hour!!!!!!!!!
Being a Brit and seeing both systems, I would take the NHS ANY day, at least we don't have to mortage our soul to gain healthare that is only slightly worse than a good NHS hospital (and yes I know there are bad ones, just the same as there are good ones ) that are available for FREE.
My Mom was a nurse for nearly 30 years, she did it because she wanted to be a nurse, it is a calling. Lets face it, in the UK it certainly is not for the money. Not so the States, they could care less for the most part, it is a good wage and that is why people do it, doctors included. **DISCLAIMER*** for the most part, obviously there ARE exceptions to ALL rules. - rotten777, on 10/12/2007, -2/+13@Pokez
A lot of good those years at school did this woman. If negligence killed a woman, then I'll personally agree with the person bashing the healthcare providers. - pumacub, on 10/12/2007, -2/+12They overcharge too.
Last time I was in the ER they sat me in a chair in the hallway and gave me an IV (no meds). The bill? $800. - NatalieMac, on 10/12/2007, -0/+10She was a black female.
Read the stupid article and stop whining.
http://www.suburbanchicagonews.com/newssun/top/5_1_WA30_VANCE_S10830.htm - gmillerd, on 10/12/2007, -0/+10I believe ya, ER's likely suck really bad ... sadly they don't have to suck really bad. ER's are likely over stressed because of bad public policy (people going to them for primary care, due to lack of health ins).
Time for a change. - NinjAlt, on 10/12/2007, -2/+11I was on the school bus when I had the accident, thats where the school sent me.
- Aesculapius, on 10/12/2007, -0/+8@ pumacub
@ daldredge
Talking about medical pricing is a large subject. Let's take a quick look.
1. ER pricing runs about 10 times that of regular office visits. Why? The intensity of service is MUCH higher than that of a clinic. The lesson here? If you think you are sick enough to get admitted to a hospital, that's a good reason to goto the ER. If not, goto an urgent care/minute clinic/etc. Most cities have extended hour clinics. Otherwise, chances are you will do ok until a clinic opens.
2. It is considered discrimination to bill differently for different people. Legally, a hospital/doctor/whatever has to go through serious legal hoops to give a discount to someone who is poor.
3. The majority of money that hospitals and clinics charge go to overhead. Support staff, nurses, medications, equipment, govermental regulations, food, etc cost a lot of money.
4. Medicare and medicaid patients make hospitals lose money. Why? They don't pay enough to cover the costs of the services that they use. What does this mean? The net loss on these patients have to be made up via the net profits of otherwise insured patients and uninsured patients (see #2). Prices are set at what they are so hopefully at the end of the day, the hospital isn't losing money.
Don't get me wrong, the cost of healthcare for the average person is getting out of control. There are a lot of reasons for this (another discussion entirely). But, please people, don't go pointing fingers at the "rich doctors" or "uncaring nurses." Trust me, if a healthcare worker doesn't want to be in the business to help people, if that's not their first reason they are doing it, they won't stay in the business long. While it is rewarding, without that drive the other negative parts of medicine (insurance companies, government regulation, threat of being sued, being on call, etc) would quickly take their toll. There are much easier ways of making a good living than medicine. - inactive, on 10/12/2007, -6/+13Bad jokes are the #1 reason for down diggs... fyi. :)
- Aesculapius, on 10/12/2007, -0/+7Of course the hospital will be sued...they have deeper pockets. But aside from that, there is a process/training issue here that is the hospitals purview.
Also, whether the doc should be sued is up for debate. Doesn't sound like a doctor ever saw the lady. - inactive, on 10/12/2007, -3/+10Skudge .. sounds like a word to describe a ***** streak on the back of someone's tighty-whities.
:) - inactive, on 10/12/2007, -1/+8It's about damn time something like this happened.. maybe people at the ER will wake up. It's the EMERGENCY ROOM. If someone comes in with an emergency, and all the rooms are full, stick them in a ***** ambulance.
I had to watch my dad suffer though ER waiting room queues so many times (probably 20 or so) in excrutiating pain (cancer). He got so fed up with it, everytime he had to go to the ER, he just called 911 because that's the only way to get in without having to wait.
I realize they're busy.. I realize they only have a limited amount of doctors.. but an emergency is an emergency and it doesn't seem like they treat them as such anymore. - daldredge, on 10/12/2007, -5/+12@Aesculapius
If hospitals didn't charge their highest prices to those with out insurance perhaps more people would pay. - 2000, on 10/12/2007, -5/+12Lois: "My sister is having a baby!"
Mayor West: "Excuse me, I was here first!" [Pushes them aside] "My leg is assleeep!" - arnaudh, on 10/12/2007, -1/+8Valium for this guy, stat!
- nodong, on 10/12/2007, -1/+8@qwickone
That is BS. I worked for years in the ER and, indeed, people do stand around chatting and doing nothing far too often. There are many great hospitals and many crappy ones--far too many crappy ones. The good ones only exist because there are so many people who genuinely care about others, but a hospital is an easy place to slack off while feeling self-important. The physician's lobby is to blame. When the government tries to regulate hospitals, they go berserk, and too many people place medical employees on an unwarranted pedestal. - deabyss, on 10/12/2007, -0/+6@daldredge
"I have been on both sides of the fence and it is crazy that a hospital will charge an insurance company 200 - 300 for a procedure they charge others 1800-3200 for."
Take up your beef against insurance companies and the health-care system. I can tell you right now that, by law, doctors and hospitals have to charge everyone the same fee for the same services. What you experienced is only the trunk of the elephant. Doctors and Hospitals, when they sign contracts with insurance carriers, agree on the prices of each procedure and tests they run. The hospitals really have no choice over this, the Insurance company holds all the negotiating power here.
In your case, The procedure you received costs $2000 but the contract would only "allow" $500 for that procedure. This is the price charged to the insurance. The remaining $1500 have to be written off (adjusted), i.e. they can't get them from you. So if you arrive to the hospital without insurance, they will still charge you $2000 for the same procedure, except now you don't have an insurance company telling them what is "allowed" to charge for it. Remember, by law, they have to charge everyone the same price. - fyrfyter, on 10/12/2007, -0/+6Here's a thought, if you are having chest pain call 911. Like this is hard to figure out. Don't drive yourself to an E.D. where some nurse who takes orders from a doctor tells you that "you're fine" and that it will take a couple of hours. Get someone on an ambulance who knows what to look for regardless of your age, sex or race.
- NinjAlt, on 10/12/2007, -17/+23I hope the family sues the ***** out of them. They're grossely over paid for the type of ***** they pull. A few years back I got into a bus accident and dislocated my shoulder. I was unable to get it back into possition and it was VERY painful. I went to the ER and ended up waiting 5 hours before someone would finally take me and then they only took my blood pressure. I then waited another 2 hours before I was lucky enough to have bent over to pick up a magazine and had it pop back in. I then left the ER. I admit that its not life threatening but a 7 hour wait is unacceptable. They could atleast give me something to take for the damn pain.
- TheThing, on 10/12/2007, -1/+7Someone get this guy a brain, I think he lost it.
- inactive, on 10/12/2007, -2/+8You comment on Skudge's racist comment, then make a racist comment yourself. Grrrreat.
- GuyHitByTruck, on 10/12/2007, -1/+6Wow, that was a brilliant display of intellegence. Go play in traffic.
- Archer1980, on 10/12/2007, -2/+7@masamunecyrus
Although i agree partly with your statement, I think your example needs a little improvement. If i walk in to an ER and say i have shooting pains in my arm, there could be one of a hundred reasons for that pain, one of which in this case is a heart attack. The guy with the broken hand is probably a higher priority then the 99 things that could have been causing the arm pain. I do think however that given this, she definately should have gotten in faster then 2 hours. I broken hand doesn't take that long for a doctor to examine and say "huh, you broke your hand i'll send you to x-ray to get it checked" and then the doctor could of done a quick diagnosis of the patient with the shooting pain and said "wow, she's having a heart attack get her into a bed now"
The problem with a lot of health care, at least here in canada not sure about the states since you ahve to pay, but our wait times get overly long because you get dipsticks that go into emerge with a runny noise, or a hang nail or something so rediculously simple. It's those people that waste the time of doctors and nurses. So, solly blaming doctors and nurses is definately not the solution.
It's kind of sad really, because now with cases like this poping up now and then, they are going to have to get extra insurance to pay lawsuits, which means less money to get nurses and doctors. And i agree with other comments that the people at the top of the hospital food chain that don't do hardly anything but supervise day to day operations, get paid WAY to much. I live in a hick town in Ontario Canada, and the head of our hospital is making over 100k, you can hire 2 nurses for that same possition, or even a doctor for that amount. - Jeebugorn, on 10/12/2007, -2/+7@pokez
WHATEVER. i can't vouch for MDs but i go to a college that it's primarily a healthcare college since 75% of the people there are in a healthcare cirriculum. and of the people attending this college 90% wouldn't be there if it wasn't for georgia's HOPE grants/scholarships which allow them to attend for free. most of those people don't give a ***** about learning anything and are there just to get HOPE and PELL checks and end up getting diplomas/degrees in nursing by default. and these are the people that are going to hospitals to treat people.
now, i'm not saying that everyone in a nursing program here is like that because i know that one of the guy's i worked for in the army is almost finished with his nursing degree since he retired from the army. he takes his schooling very seriously and always had the highest score in his class...with most of the other people gettin F's. if only everyone else in the nursing programs had his dedication. - RobotCitizen, on 10/12/2007, -1/+6Monday morning quarterbacking is one of the easiest things to do in medicine. It's easy to look back and call a patient's symptoms "classic" when you weren't there. The truth is that a good 1/3 of all heart attacks do NOT present with the classic TV symptoms, and getting a clear-cut history out of a patient is very often like pulling teeth. For example the woman's primary complaint may have been nausea. She may just have mentioned some chest discomfort in passing, without describing it clearly, so maybe she was triaged as a simple gastroenteritis or a flareup of acid reflux. Maybe she's got emphysema and is short of breath all the time anyway. Maybe she's got anxiety disorder. Maybe she's diabetic and therefore far less likely to experience classic chest pain during a heart attack.
Diagnosis is a grey art, not black and white like lawyers would have the public believe. And getting a clear story from a patient can often take a solid 20+ minutes of questioning, sometimes interrogation. That's time that ER staff usually doesn't have. The armchair generals with no medical training need to stuff a sock in it. Medical information related by the media is NOT medical information. It's drama. - actionjackson, on 10/12/2007, -1/+6This is absolutely inexcusable. We live in a country where as much as 30-35% of the population has no health coverage. According to a recent story on NPR, Americans (or at least the 70% who have coverage) pay more than most other countries for healthcare, but the quality of care is greatly disproportionate to many of these other countries. The conclusion is, unlike what we americans think about most things, paying more does not get you a better result.
Our healthcare system sucks ass, and this poor lady in Chicago is unfortunately only a "celebrity" victim of this mammoth pharma.-gov't conspiracy that takes the lives of silent thousands every year due to sheer indifference and contemptuous greed.
***** travesty I tell you. - zionad, on 10/12/2007, -0/+5@Aesculapius: Very true, I love how inexpensive our health care is in Canada, but the wait times are completly ridiculous sometimes..
- cryptocom, on 10/12/2007, -0/+4I agree that it should be treated as a homicide. That is the only thing that is going to get the states to designate more money to the hospitals so they can hire more nurses and physicians. I agree that that it may not have been the fault of the overworked, understaffed crew on duty, but that doesn't excuse the fact that an innocent person who needed urgent care was not treated. I feel strongly about this because I, as a long time diabetic, have been in the hospital 3 times due to diabetic ketoacidosis (extremely high sugar resulting in acidic levels in the blood stream...usually caused by sickness and stress). All three times I went to the ER, and then spent about a week in Intensive Care, and then another week undergoing treatment and recovery. This type of situation is just as urgent as a heart attack...it will result in death if not treated immediately. The last time I was admitted, they took nearly 30 minutes to start me on IV insulin to lower the sugar, and IV morphine to stop the abdominal convulsions and cramps that were not allowing me to breath. I nearly died...and it would not have been a quiet, peaceful death. It was extraordinarly painful and traumatic.
So, while I can sympathize with the staff doing it's best to get to everyone in need, I believe that this sort of drastic judgement is necessary to get the state to move it's butt and start allotting more money for the medical facilities. - arnaudh, on 10/12/2007, -0/+4"But part of why we pay more is because a lot of the research is done here - we export the expertise."
Actually, that's not really the case anymore. We now have to import the expertise. A lot of the top scientists hired by labs and universities come from abroad, because the talent is getting scarcer in the US. And we have to import nurses from the Philippines and other countries. - NinjAlt, on 10/12/2007, -2/+6@Dragular
I'm all for them helping someone who is dying first. However 7 hours with no help is not how a hospital should work.
PS: I would like to see you dislocate a shoulder. It feels just as bad as any broken bone ever could. There have been football players who have been put to tears with a dislocated shoulder.
Also, I was the only one and I use this word loosely, seriously hurt. - NapoleonGold, on 10/12/2007, -3/+7Wow,
Hopefully this will impact our AWFUL healthcare system.
But in reality it will probly just cost more to go to the ER - Krispy, on 10/12/2007, -4/+7This is nothing but a testament to the failure that is the America health care system.
- apetrie, on 10/12/2007, -1/+4Pokez: That is not a realistic picture of socialized medicine at all. I don't know if you're saying that in the U.S. people on welface get this "I demand you treat me now" card, but they certainly don't in Canada. Seriously, where did you get this all from? Its just *not* the way things work!
- crackhammer, on 10/12/2007, -0/+3nothing clever to write here - just...sad
- inactive, on 10/12/2007, -1/+4I love you, Skudge.
- inactive, on 10/12/2007, -0/+3The bottleneck is actually the spots they allow for medical school and the arbitrary extremely high cost of it. In Canada they complained for years that they didn't have enough doctors, but the union of doctors basically controls the available spots in medical school and didn't make any more (a stupid attempt to raise the price of their services). So the government more or less opened up immigration and now "they took our joobbsss".
- Pokez, on 10/12/2007, -4/+7I admit, the incident with the woman in the article was unfortunate, and it was up to the triage nurse to make the call( she/he should have done the whole heart attack checklist when she walked in) but this does not happen often, and was the incompetence of one person, it does not reflect to the people in other ER's
- apetrie, on 10/12/2007, -0/+3I never said it was so great, I just said his representation of it is false. If you want to criticize something, at least be critical of what it really is.
- Pokez, on 10/12/2007, -5/+8@pumacub & daldredge
Read his post, "Many poor and uninsured people use the ER as their regular doctor with no intent or capability of paying", if the hospital didnt have to eat the cost here they wouldnt have to over charge. Trust me, the ER is the LEAST profitable part in a hospital, if it makes in money at all. -
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