Just a quick vent ... another entry in the Perception is Everything book.
The other day an ER patient (not my patient) with chief complaint of SOB x 1 week was diagnosed with bronchitis and discharged. Not my patient, but I had the patient in the next curtained area and I was in there for quite a while, so I no choice but to hear how the other patient's ER visit played out.
Patient (young adult, no other significant PMH), had fever @ 101 F, was medicated with antipyretics and abx. CXR was clear. No respiratory distress, able to speak in complete sentences and ambulate without difficulty. Discharged with Rx for continued abx and instructions for rest, fluids and OTC Tylenol/Motrin. Also advised of worsening s/s which could indicate need for return to ER. MD and RN leave, patient is getting dressed and makes a phone call to significant other:
Patient: "Well, they say I have bronchitis and they don't want me to stay because I don't have insurance."
Significant other must have questioned this, because he repeated it twice more.
WHAT????? :trout:
I'll be the first to admit that the uninsured face enormous difficulties in getting primary care, but I wonder how common this is -- the perception that the patient is somehow being short-changed in not getting a "million dollar workup" and inpatient admission when in reality ... it's just not medically required.
