Experience from the outside-

Anyone who reads this blog on a regular basis, knows I have not posted for a while- I have been quite busy, but check back occassionally and discovered an e-mail from an internist stating "Dear Doc,It's not called the American Trial Lawyers' Association anymore. It's been renamed the American Association for Justice. Is that hilarious?" Brian McCarty is an internist who has a website and I actually found it quite interesting! Below is something I pulled from the home page... Thanks, Brian!!
Cross-Examination
Posted 3-22-08
Q:
Doctor, before you performed the autopsy, did you check the pulse?
A:
No.
Q:
Did you check for breathing?
A:
No.
Q:
So, it is possible that the patient was alive when you began the autopsy?
A:
Well, let me put it this way. The man's brain was sitting in a jar on my desk. But I guess it's possible he could have been alive and practicing law somewhere.

So how are those statistics?
So many reports/studies, etc. has gone into figuring out why it's such a difficult task- Everyone tries to find solutions, everyone has answers and thinks they know the "real" issues. As you will see, below, I have found yet another source defining those issues- This came from The Hospital & Health System Association of Pennsylvania. While all of this information seems very accurate, I would LOVE to know why we can't come up with reasonable solutions- across the board.


Many Roles and Responsibilities
The hospital emergency department is the first place that people turn to when they
have an injury or illness that needs immediate attention. It also provides much of
the medical care for patients without medical insurance, or for patients whose
physicians are unavailable evenings and weekends. Emergency departments are safety nets for those with
behavioral health problems, a safe haven for communities in times of disaster, and many are designated trauma
centers prepared to treat the most serious and complex health care emergencies.
• The number of visits to
emergency departments has
increased nationwide by 28
percent. However, the number of
emergency departments available
to meet health care needs has
declined, with 437 emergency
departments ceasing operations
nationally during the past 10 years
(1997‐ 2006).
• In Pennsylvania, the number of
emergency visits increased by
more than 21 percent, while the
number of available emergency
departments decreased by 17
percent.
Emergency Care Trends Strain
the System
• Emergency departments are used more frequently than physician offices by Medicaid, self‐pay, and charity care
patients.
• People without health insurance access the emergency department for health care and they often wait until
they are very sick before turning to the emergency department for help.
• Elderly patients with worsening chronic conditions use the emergency department because of ongoing needs.
• Driven by the closure of state psychiatric hospitals, a decline in inpatient psychiatric beds, and low
reimbursement rates for mental health services, a growing number of seriously mentally ill patients are going to
emergency departments.
• The growing threat of a disease outbreak or terrorist attack raises public expectations of the role of emergency departments in their community.

Over the weekend I had my own ED experience and it was not pretty. Since I write about how people abuse the emergency department, I think it has almost been dangerous for my loved ones- I don't react. So... maybe some of you have experienced this:
daughter: "Mommy, my stomach is KILLING me"
me: "you will be fine- do you have a test tomorrow?"
daughter: "MOM, NO- I really don't feel well!"
me: "well, you will have to tough it out- I don't feel well either, but I still have to work- you are going to school tomorrow! You better go to bed. Sleep will help."

Later in the evening, she starts vomiting GREEN BILE and it goes on for HOURS- I am now absolutely CONVINCED that it's food poisoning- She had Salmon earlier in the evening and I am convinced it was a bad piece of fish. I encourage her to "puke" thinking she is going to have a rough couple of days, but will be fine-
2:00AM- daughter " I AM GOING TO DIE- DO something MOMMY"
me "I am begging you.... pleaseeeeee let me sleep- just for two hours! If you want me to be there for you tomorrow, I NEED to sleep"
3:00AM I begin to realize this must be more than food poisoning- She is becoming dehydrated and I am feeling like an ass-
4:00AM I finally decide to take her to the local emergency room- (where I don't know ANYONE)
5:00AM get to the ED, go to Triage and there is absolutely ZERO waiting!!!! I was BEYOND impressed! I was planning on coming directly home once this was over and blogging EVERYWHERE about how SUPER this hospital was!!!
6:00AM- waiting in room for an hour, daughter still in horrific pain, FINALLY Dr. #$%^&* enters the room- Checks her belly, orders Ultra Sound- (pain in upper right quad, no fever) Orders Morphine for pain- it doesn't help. We move on to Dilaudid- finally SOME relief.
10:00AM- (have not seen Dr. since initial visit at 6am) Ultra sound is neg. He decides to order CT Scan- tells me he doesn't really think anything will come back- but you know, "just to be safe" we should do it.
She starts to drink contrast- 12pm- FINALLY go to CT Scan- 1:00 DO OVER... not enough in her system... more contrast- more waiting-
I could continue on and on... bottom line- It took this emergency dept. sixteen hours to figure out that my daughter needed and emergency appendectomy. She finally went to surgery at 10PM- and was FINALLY in a room at 1am.
Of course I must add- my daughter's VERY first words after arriving to her room post op
"AND YOU THOUGHT I WAS FAKING IT" Was she trying to do me in for good?!!!!! AHHH!! Anyway- After ALL of the time spent working in Emergency Depts, with ALL kinds of medical staff, was THIS my PUNISHMENT?! Even as I write this blog, I am dreaming of the words I will write to hospital administration-
I guess I need to take people more seriously vs. dismissing every ache and pain- we could have been in BIG trouble!!! I am sure she will NEVER let me live this one down!!!