Thursday, October 31, 2013

I don't work in an ER anymore

It is getting to the point of ridiculousness with the tests that are ordered in the emergency departments.  I mean for shits sake PET scans, stress tests, CT cardiac angios.  MRIs are commonplace.  Its like the hospital purchased all this shit so it has to be  used.  Here's the thing, when you are ordering all these sophisticated tests, people stay for hours on end in the ER, taking up beds.

Don't even get me started on the 20 fricking orders for every patient that comes in.  I mean seriously if you have a stubbed toe you get an IV and dilaudid and maybe a little zofran for your probable nausea.  We are no longer an ER but a outpatient high acuity med/surg/tele/neuro diagnostic unit.

These days there are 3 groups of people who use ERs on a regular basis:

1) elderly people
2) poor people who use us as a clinic
3) the chronically ill

The other people are going elsewhere, either to their doctors or urgent care.  Urgent cares are popping up left and right.  It seems like we are not getting much of the smaller trauma like fractures, lacerations, minor MVAs anymore.

I mean lets just call this what it is.  It isn't emergency medicine anymore


jimbo26 said...

It is happening like that in the UK . Due to ' cutbacks ' , the government is closing hospitals and downgrading ERs to Urgent Care Centers ( at the hospitals still open ) . My local hospital lost its ER and maternity unit , and is becoming a campus .

Anonymous said...

They do MRI's in your ER? When I had neck problems with a suspected herniated disc and severe pain I was told "we don't do MRIs in the Er". Could have been because I had no insurance.