Quote from scribblerrn
I would like to make my complaint from a primary care provider point of view. I am continually amazed at the amount of our patients who go to fast track in the middle of the night and during our after-hours (The ED is nice enough to send our office a sheet or two describing the visit). And we have 24 hour doctor call and hours on Saturday (I have sent non-critical pts to the ED on Sunday due to our lack of office hours, so you can blame me for that!) Most of the patients have used the call service and was informed by the MD or NP on call how to treat at home and that we would see them in the morning! When I've been on-call, I would even give them a time to come into the office during the first 2 hours we were open to be seen. Stilll, there they are at the ED.
I do get a secret satisfaction sometimes. Our local fast track is very slow with long waiting times. Usually if a pt calls after 10PM and I offer them an appointment, which they will take, then go to fast track, not tell us and no show for their appointment-
. At the ED they will be awake all night in the waiting room and are usually seen about the time I offered them to come to the office. I know this because the fast track tells them to follow-up with us, so they come to the office and complain about how they were up all night at the ED and weren't seen for 10-12 hours. I then get to say in my NICEST voice, "ED waiting areas can be pretty bad, that is why I tried to offer you an early appointment time here."
I can understand going to fast track for terrible pain, etc, but it seems the majority of our pts/ families just don't want to get out of bed in the morning and usually don't start waking up until the afternoon and by that time, there is no WAY we can fit you in before we close for the day.
I for one wouldn't mind getting rid of the fast track since it would mean our pts would actuallty go to the primary care provider!
I am right there with you, except
that they'll go to the ER, fast track or no fast track!!
I have never
understood that preference for the ER in the middle of the night to the clinic in the AM.
Most of the things I see which have gone to the ER could be treated perfectly well in the clinic and are not emergent. Things like, for example, diaper rashes and vomiting x 3.
I have been doing this:
for years with patient/parent education and sometimes feel like a hamster on a wheel. I think sitting through education on what is or is not an emergency should be a prerequisite to getting the Medicaid card!!
Even when parents are told that there is someone on call and to call before going to the ER, except in very limited and specific circumstances, many don't bother to call. I've had weekends on call and then on Monday seen the six or eight or ten ER reports from people I never heard from. And most of them were not seen for lacerations, broken bones, or retractions/grunting in an infant.
I've had parents call, 10 or 11 PM with a problem, ask "Can I take him to the ER?" I ask my questions, give instructions, then offer an appointment: "Can you have him in to the clinic at 8:15?" "Uh. Well, do you have anything after lunch???" I'll give them 1 PM if that will keep them out of ER tonight.
To those in the ER: Most of us in primary care try to keep our folks out of the ER. We would really rather see them ourselves, because that offers us the opportunity to look at things that you don't have time for and shouldn't be concerned with anyway, like management of chronic problems. Please try to have patience with us when we do send patients in to see you for things you don't think are important. Sometimes what we hear on the phone and what you see in person don't bear much resemblance to one another. That kid taking apart your waiting room might have been described to me as being on death's door. Or, something might have been so "iffy" that I really wanted someone to lay eyes and/or hands on the patient. And I will admit that on occasion, I'll send someone in on a Friday or Saturday night rather than suffer with a UTI over the weekend because I'm not about to call in antibiotics for someone I've never laid eyes on. I haven't done that often.
All that I know to do is to keep on with the education, and to manage my patients' chronic problems to the best of my ability. I would like for my patients to be strangers to the ER, only seen when they have the misfortune to get injured.
Thank you to all you ER folks, fast track or no. You do a fantastic job under often difficult circumstances and I do appreciate it!