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N=1, or, Story Time! In 2017 my wife and I were living in Portugal for several months. When we needed to refill her prescriptions, our short-term rental host s

N=1, or, Story Time! In 2017 my wife and I were living in Portugal for several months. When we needed to refill her prescriptions, our short-term rental host said, "Go to the ER." Backstory: we're well familiar with ERs in the U.S. Due to various conditions, we've been to at least a dozen ERs a total of perhaps twenty times. For anyone who doesn't know, unless you are actively dying, visiting the ER in the U.S. is sloooow. The average time to see a doctor, in our experience, is about an hour. So we replied: "the ER? seriously?" He assured us it would be fine, so we walked ten minutes to the ER and signed in. We had barely turned in the history paperwork when they called us to go back. No preliminary check-in with the nurse -- straight to the doctor. She said, "Why did you come to the ER? We could have been busy and you would have had to wait." We explained how our host had assured us this was the best way to go, and that the ER would take care of us. The doctor nodded and said, "Sure, I'll sign for the prescriptions, but just remember it might take more time the next time." We went back to the front desk. Remember, we had no travel insurance, this was full freight. "That will be twenty-eight euro." We happily paid, and walked out the door, prescriptions in hand, less than 30 minutes after we walked in. Bonus: the cost to buy the prescriptions, again with no insurance, was less than the co-pay in the U.S. with employer-healthcare. N=2: When my daughter was visiting me in Bangkok, she got a bit of a gastro issue. Same as in Portugal, we had no insurance for her. I took her to Bumrungrad, one of the best hospitals in Thailand. We were in and out in under an hour, including picking up the prescription, and the total cost was under $100. I'm not trying to rebut the article, just throwing out some details.

qup 2y ago
> visiting the ER in the U.S. is sloooow. The average time to see a doctor, in our experience, is about an hour. This is such a bizarre couple of statements for me. First, I would consider an hour very, very fast. If I show up for an appointment on time, I still don't see the doctor for about an hour. And for a non-emergency emergency room visit (even a fairly serious one like a broken bone, abscessed tooth, etc) I've had family give up after 8-12 hours of waiting in the lobby without being admitted to see a doctor, often in relatively empty lobbies. (The hospital is hoping for this, I'm sure)
- eszed 2y ago
  That stood out to me, too. The fastest I've been seen in a US emergency room was when I presented with an infection laying red tracks up my arm (cat bite: I'd been to the GP in the morning, but his antibiotics weren't working). That was a 3.5 hour wait, during which the infection progressed a further six inches. My sister once bailed after 12+ hours, when the doctor's office that instructed her (in no uncertain terms) to take her child in was about to open the next morning.
  - gcanyon 2y ago
    Yikes, sorry to hear about that awful experience. I could be underestimating, but we've gone to the ER on at least... three occasions where the situation was clearly immediately life-threatening and seen the doctor immediately upon arrival. Then there are the times we've arrived not by ambulance and waited up to about six hours. I don't think we've ever waited 12+ hours, that's terrible. N=5 (I checked in with my wife about two times she went to the ER in Nepal, and I went to Bumrungrad once in Bangkok), but our average time abroad has been under 30 minutes, and that includes the prescriptions in Portugal and getting eyeglasses in Nepal. Only one time was serious, in Nepal, and they saw her immediately then.
    - eszed 2y ago
      I tend to elide this experience - feel free to speculate about my psychology around the event: I do! - but when I had a stroke (in the US) I was seen very quickly. In A&E (UK for "ER") departments I've seen (half a dozen experiences, mostly attending with others, all for non life-threatening conditions) wait times ~an hour, about which staff were apologetic. (I understand those expectations may have changed under Tory sabotage.) This whole thread, while interesting, highlights how variable N=1 anecdotes can be. We're poorly served when we base conclusions only on our own experience. (Though I still think US-one-hour guy is a fortunate outlier!)
      - gcanyon 2y ago
        US-one-hour guy here: > fortunate outlier Not exactly how I would describe it :-) I: - Hit the ER with two collapsed lungs in an ambulance after a motorcycle accident: saw the docs immediately (I assume, I don't remember it) - Hit the ER with intestinal blockage after the motorcycle accident, had vomited something like fifty times during the night and was actively bringing up bile as we checked in: they saw me in maybe an hour - Hit the ER with a suspected deep vein thrombosis: I think they knew it wasn't that serious, but still saw me in <30 minutes - Hit the ER with *actual* deep vein thrombosis: they saw me almost immediately and almost didn't let me leave that day. And then there's my wife, who has several things going on that aren't mine to disclose, but that tend to put her toward the head of the line.

qup 2y ago

> visiting the ER in the U.S. is sloooow. The average time to see a doctor, in our experience, is about an hour. This is such a bizarre couple of statements for me. First, I would consider an hour very, very fast. If I show up for an appointment on time, I still don't see the doctor for about an hour. And for a non-emergency emergency room visit (even a fairly serious one like a broken bone, abscessed tooth, etc) I've had family give up after 8-12 hours of waiting in the lobby without being admitted to see a doctor, often in relatively empty lobbies. (The hospital is hoping for this, I'm sure)

eszed 2y ago
That stood out to me, too. The fastest I've been seen in a US emergency room was when I presented with an infection laying red tracks up my arm (cat bite: I'd been to the GP in the morning, but his antibiotics weren't working). That was a 3.5 hour wait, during which the infection progressed a further six inches. My sister once bailed after 12+ hours, when the doctor's office that instructed her (in no uncertain terms) to take her child in was about to open the next morning.
- gcanyon 2y ago
  Yikes, sorry to hear about that awful experience. I could be underestimating, but we've gone to the ER on at least... three occasions where the situation was clearly immediately life-threatening and seen the doctor immediately upon arrival. Then there are the times we've arrived not by ambulance and waited up to about six hours. I don't think we've ever waited 12+ hours, that's terrible. N=5 (I checked in with my wife about two times she went to the ER in Nepal, and I went to Bumrungrad once in Bangkok), but our average time abroad has been under 30 minutes, and that includes the prescriptions in Portugal and getting eyeglasses in Nepal. Only one time was serious, in Nepal, and they saw her immediately then.
  - eszed 2y ago
    I tend to elide this experience - feel free to speculate about my psychology around the event: I do! - but when I had a stroke (in the US) I was seen very quickly. In A&E (UK for "ER") departments I've seen (half a dozen experiences, mostly attending with others, all for non life-threatening conditions) wait times ~an hour, about which staff were apologetic. (I understand those expectations may have changed under Tory sabotage.) This whole thread, while interesting, highlights how variable N=1 anecdotes can be. We're poorly served when we base conclusions only on our own experience. (Though I still think US-one-hour guy is a fortunate outlier!)
    - gcanyon 2y ago
      US-one-hour guy here: > fortunate outlier Not exactly how I would describe it :-) I: - Hit the ER with two collapsed lungs in an ambulance after a motorcycle accident: saw the docs immediately (I assume, I don't remember it) - Hit the ER with intestinal blockage after the motorcycle accident, had vomited something like fifty times during the night and was actively bringing up bile as we checked in: they saw me in maybe an hour - Hit the ER with a suspected deep vein thrombosis: I think they knew it wasn't that serious, but still saw me in <30 minutes - Hit the ER with *actual* deep vein thrombosis: they saw me almost immediately and almost didn't let me leave that day. And then there's my wife, who has several things going on that aren't mine to disclose, but that tend to put her toward the head of the line.