This is why ERs are used as PCPs

Nurses General Nursing

Published

Perfect example:

2 of my kids were running a fever for 24 hrs, then both started with sore throats, and both had white patches all over their tonsils. I call the MD at 9 am who has new office staff and tell them I'm fairly certain that both of my kids have strep throat and would like to get them in to be seen by the dr. New office lady says "we are all filled up today and tomorrow, then the dr goes on vacation, so you will have to wait a week and a half until he gets back and bring them in then. Ok? Bye." and hangs up before I could even say anything. :banghead:

There isn't an urgent care center here. The only alternative is the ER. How ridiculous is that?? I called back and pushed the issue, and said that they couldn't wait a week and a half to be seen. She got this huge attitude and said "well, I'll go ask". Comes back and says "You can bring them in but you'll have to wait a long time since the other scheduled pts will be higher priority." and hangs up again with out saying anything else.

They got in, did the in office screening for strep, both came back positive.

Not only did she expect for me to wait a week and a half for a sick visit, but she was COMPLETELY rude on top of it.

If we weren't moving, I would change PCP, never go back, and write a letter to the dr and explain why.

Specializes in Women's health & post-partum.

I joined an HMO (Kaiser) when my kids were small (my gosh, that was 30 years ago!) and was very pleased with the way they handled pediatric "walk-ins". I always called ahead and never had to wait more than half a day to be seen--usually less. Wonderful when you have a kid who manages to get ear infections at least 4 times every winter.

as an aside; The ear infections cleared up when her daddy quit smoking.

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Specializes in Emergency Room.
I had to do this recently. I had vomited a bunch of times and blood a couple of times and my doctor could not see me that day. My school nurse at college told me that i either needed to see my doc THAT DAY or go to the ER. I was embarressed to go to theER for that but I had no choice really, the nurse knowing me, planned to call an ambulance, but I promised that I would go. I decided I would at least go to the hospital that I am already a patient at since they have all my history.

I was embarresed to be there but I was told by my nurse not to worry. That it was good I went because I was dehydrated.

I am 20 (and was when I went) last time I had been in the ER was when I was 5. So I do not go there very often.

there was nothing your pcp could do for you anyway. you needed IV hydration. the ER was totally appropriate.

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Specializes in Cardiac, ER.

"there was nothing your pcp could do for you anyway. you needed IV hydration. the ER was totally appropriate. "

Many FP offices (including mine) give IV fluids,.IV antibiotics etc.

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Specializes in Maternal - Child Health.

Please write the letter, and then copy it to your insurance company. They need to know why they paid several hundred dollars of ER charges instead of a PCP visit.

I once complained long and loud to my insurance company over the lousy choice of OBs in our area. I worked OB and knew who the good and bad ones were. They promised to consider my suggestions. I thought, "yeah right!" A few months later, the plan dropped some of the lousy OBs and added others who were much better physicians. I don't really know if I had anything to do with that change, but it never hurts to try!

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Specializes in Home Care, Hospice, OB.
this is why i love the family pratice i see they have an np who takes nothing but call in cases - i have never had to wait more than 15 min to see a dr for the kids, they can treat the whole family its just awsome if there are any doc lurking here that can copy this set up you will have the busiest pratice in town with happy patients to boot! love my doc who treats his staff like gold..

my pcp has a designated md for this--no caseload of his own, just the emergent visits. it is great--and he can get his hands on the "real" chart, so there is continuity!!!:yeah:

ps-if you live in lynchburg, va, pm and i'll share them!!

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Specializes in Hospital, med-surg, hospice.

I have known people with no health insurance to call a Dr office only for an urgent problem only to be told "We don't accept pts without insurance" even when offered $100.00!! so what can the poor or "uninsured" do? Most people would like to avoid the ER but if a fever, chest pain happens what can you do??

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Specializes in Maternal - Child Health.
I have known people with no health insurance to call a Dr office only for an urgent problem only to be told "We don't accept pts without insurance" even when offered $100.00!! so what can the poor or "uninsured" do? Most people would like to avoid the ER but if a fever, chest pain happens what can you do??

No one would fault a patient with chest pain for using the ER.

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Specializes in Med/Surg.

I learned long ago to ask to speak to the triage nurse or the MDs personal nurse/assistant. The appointment desk will tell you that every single MD is booked for the day. When you talk to the triage nurse, amazingly, there is an opening or two!

(Just happened to me yesterday!)

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Thankfully my MD still uses voicemail. I've known her since I was 14-yrs-old, and I can just tell the desk to put me through to her voicemail. For most things, she'll just call in a script for me or my kids. My husband is a different story tho, she's only known him for 5 years, and usually wants to see him first.

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Specializes in Emergency.

I've stated this in other posts before - I don't mind seeing fast-track patients (sore throat, lac, etc), as long as the patient/family are respectful to me.

I'll be triaging and suddenly a mom will start yelling at me for not calling her name yet (and she's bringing in her kid for antibiotic ointment and a bandaid "cause I don't have that at home"), as I am rushing back a patient complaining of 30-minute chest pain that "feels like an elephant on my chest".

It's the patients that say "hurry up, I gotta go to work" or "how much longer is it going to be" that irk me. I gently remind people that we are working as fast as we can, but critical patients need to be seen first. If I get the "well I'm really sick too" line, I'll let them know that there are other people needing assistance with breathing and chest compressions because their heart is no longer beating. That usually shuts people up - but some of these complainers still continue on and say "what do you mean - there are people here dying?" Duh, this is the emergency room, not Pizza Hut. What really shuts up these people is when they see me run out to the parking lot, pulling out an unresponsive patient from a car and running them in back. "Wow, they're really sick". Um, yeah, this is the ED.

But no, I welcome "polite" fast-track patients. I've been told by my doctor before to "go to the ED" when I've called for minor medical problems and they can't fit me in. So I totally understand the system, and sympathize. A "wow, you guys are really busy, thanks for seeing us so quickly" makes my day (isn't that sad?). We usually get our fast-track patients in/out under one hour, and our main area has an average length of stay under 3 hours. Not bad, considering in other states some people wait in the waiting room for up to 8 hours before even seeing a doctor. Our ED sees 220+ patients each day.

So, if your doctor can't/won't see you or your family, come visit me! Just don't yell at me, curse, complain that you need to get to work and we're taking too long, or state "I'm not going to be able to fill this antibiotic for my kid's ear infection until tomorrow night", even though the pharmacy is 2 blocks away. In my mindset I think "if your kid is sick and you seek emergency care, you better follow through and pick up that antibiotic and some tylenol on the way home".

My latest motto has been "Serenity Now!"

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I have known people with no health insurance to call a Dr office only for an urgent problem only to be told "We don't accept pts without insurance" even when offered $100.00!! so what can the poor or "uninsured" do? Most people would like to avoid the ER but if a fever, chest pain happens what can you do??

That isn't right!:spbox: They should at least see the pt. if the problem is serious enough. The clinic I use will see pts. without insurance.

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