Two Florida hospitals now charge extra for non-emergency ER visits

[NRSKarenRN]

found at healthleadersmedia.com:

two florida hospitals now charge extra for non-emergency er visits

in mid-november, orange park medical center became the second northeast florida emergency room in recent months to ask the least sick of its patients to turn elsewhere for care or face a $100 fee. memorial hospital in jacksonville started the policy in august. both facilities are operated by hospital corporation of america.

florida times-union, nov. 30, 2006

[DarrenWright]

Proper training? I believe that is called NP/PA/Med school. And the reason triage is staffed with RNs and not MDs is all about resource allocation. Why would an ED want to take a doc away from the back where they can see pts and get them out of the department to just triage people? I do not do an EMTALA screen in triage. I use my nursing judgment to determine if this patient can wait for the MD eval, or if they need to be seen emergently.

Sheeesh...you missed the point, and you cannot make your opinion an absolute.

EMTALA, as it's written, allows nurses to conduct the screening for an emergency as defined by EMTALA as long as it's hospital policy, and before you focus on the "hospital policy" bit, you need to realize that EMTALA defers to 'hospital policy' on many issues.

You didn't have to explain why a physician doesn't do triage, but you obviously didn't understand what I was saying.

[JessicRN]

My insurance you have to call your if it is not a code you have to call your PCP they decide if you need to go to the ED. When you get to the ED if you are not admitted you pay $100 copay if you are admitted you pay nothing.

Why should everyone else be treated differently. Seems to me I am the one currently being disrcriminated against because I pay for my insurance. I do work in the ED and the number of missed diagnoses are few and far between. We have become a primary care ED where patients come in with a multitude of non emergent problems and we have to tend to address them all . (i.e we had a 24 year old come in with Chest pain for 3 months, in her visit not only did we work her up for that she also had lady partsl drainage which she developed later and had a pelvic exam and she had a sore knee from an MVA she had a month ago and got xrays for that as well) she went home happy as a clam, she got a complete physical for nothing and did not have to make an appt with her PCP.

There had to be more policing after the fact. A child with a fever for one hour with no change in the childs behavior without taking the temperature or giving them anything or calling their own pediatrician because they "don't want to bother them"should be addressed and yes if they went to the doctors, the doctor would have charged them a copay at the office they should get the same copay in the ED.

In our hospital we are a public health hospital we provide free care to any indigent or illegal pt. That includes PCP's that take free care or you pay by sliding scale. There is no excuse anymore. It is simply using the ED because there is only a wait of hours instead of days (except these are usually the biggest complainers when they have to wait extended periods of time), you can get your lab and xray results immediatley instead of waiting of course it is more convenient because you can come anytime. You can also lie about your name and address and not get any bill at all or use your cousins free care or medicare without anyone checking.

It is true many places don't have the benefit we have provided but our place proves giving a person everything will not stop them from coming to the ED for non emergent things, we make it too easy to abuse we have made an express care where the non emergent get seen before the true emergencies. Something has to be done.

What people do not realize is ED's are closing because there is so much loss of money from non payers. EMTALA and COBRA is killing them and us. Also just think when you have people on medicare (paid for by the taxpayers) who go to the emergency for non emergencies and what should have costed $50 dollars at a doctors office now costs us $1000's. Calculate the savings. When you or your family member have a true emergency and find your hospital ED is closed or you or someone close has to wait 8 hours for a bed in severe abd pain or you get stuck in the hall with true cardiac pain because that 24 yr old I spoke of earlier is occupying a bed you will feel differently I am sure

[jjjoy, LPN]

JessicRN - You seem quite passionate about this and I agree with much of it. I think you're preaching to the choir for the most part here. There's got to be some good campaigns out there that you can join up with in order to have your voice heard in wider society. It can be painfully slow to try to change things, but any effort beats no effort. Even just signing petitions can make a difference. There ARE things we can do influence change, little by little.

[teeituptom, BSN, RN]

Right on this should have happened a long time ago.