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Everytime I've gone I see regular people spend 8 hours+. No one is looking for a roof over their head or a doctors note. The ability to pick and choose who r
by ipaddr 3y ago
Everytime I've gone I see regular people spend 8 hours+. No one is looking for a roof over their head or a doctors note. The ability to pick and choose who requires care sooner is overrated.
- skyyler 3y agoI can assure you that emergency room triage is not “overrated”.
- ipaddr 3y agoI can assure you if you come via an ambulance you will get pushed to the front of the line over a walk in. Easy to triage things gun shots are not so easy when the problems are internal. Easy to introduce bias. Parent poster thinks homeless and poor are only there because its warm or they have nothing better to do. It's okay to keep them waiting over someone who looks rich. They must have a serious problem, look at how well dressed they are. Our medical system is still in the stone age.
- hundreddaysoff 3y agoWhat is an alternate solution? In hundreddaysoff fantasyland, the solution is to fire all the bureaucrats and triage everyone immediately. But, then nursing primaries and secondaries and all the other required paperwork wouldn't get done and CMS would come shut down our hospital.
- ipaddr 3y agoSchedule more doctors. Hire people to do more paperwork.
- inemesitaffia 3y agoThere's a shortage
- hundreddaysoff 3y agoThere is no shortage of practitioners, ie ~medical middle managers such as myself and other MDs/DOs/NPs/PAs, willing to work in the ER. (In the narrative of one faction, the suits have in fact created a surplus of us, including docs, that will only get bigger in the next 5 years, possibly hitting n=10,000+ surplus ER docs by 2030. If that happens, a major reason for that in this narrative would be that the suits have directly funded more Emergency Medicine residency slots opening in that time than there are interested American medical students applying to the specialty.) There is no shortage of bureaucrats willing to shuffle paper and create more work for themselves in the name of Quality or whatever. See this doc's blog for a relatively balanced take on this growth, but I do think there is truth to his first graphic: https://investingdoc.com/the-growth-of-administrators-in-health-care/ https://investingdoc.com/the-growth-of-administrators-in-hea... In my understanding, there is a critical shortage of RNs willing to provide the actual hands-on patient care, for pay that will still turn a profit for the hospital. This includes skilled ER triage nurses. But the other side of the coin from labor shortage in this problem is, again, that hospitals simply are not reimbursed sustainably to serve many ER patients, particularly self-pay patients, in the non-literally-emergent ways that those patients should be served, would like to be served, or deserve to be served medically. Ie, in my understanding the ER is often a loss-leader for a hospital that serves to get patients into higher-total-reimbursement clinics such as GI, cardiology, and orthopedics. Again, I'm not trying to argue for any faction here including doctors/midlevels, RNs, hospital admin, or even patients. I'm just trying to describe the system from my view down my periscope over 8+ years of doing this.