Thursday, April 02, 2009

Wanna know where your healthcare dollars are going?... Just One of the ER Problems...

We've been pretty busy lately at the Brownell Household, what with baby on the way, Olivia at 18 months and wild as ever and building the new house. Throw in my crazy work schedule, and it's hard to spend time with many of my hobbies, including reading your blogs and blogging on mine. I did want to share this story I just read though, and you can get a glimpse of one of the problems with our healthcare system...and why I'm so damn busy in the ER some days:

9 patients made nearly 2,700 ER visits in Texas

AUSTIN, Texas (AP) — Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients.

"What we're really trying to do is find out who's using our emergency rooms ... and find solutions," said Ann Kitchen, executive director of the group, which presented the report last week to the Travis County Healthcare District board.

The average emergency room visit costs $1,000. Hospitals and taxpayers paid the bill through government programs such as Medicare and Medicaid, Kitchen said.

Eight of the nine patients have drug abuse problems, seven were diagnosed with mental health issues and three were homeless. Five are women whose average age is 40, and four are men whose average age is 50, the report said, the Austin American-Statesman reported Wednesday.

"It's a pretty significant issue," said Dr. Christopher Ziebell, chief of the emergency department at University Medical Center at Brackenridge, which has the busiest ERs in the area.

Solutions include referring some frequent users to mental health programs or primary care doctors for future care, Ziebell said.

"They have a variety of complaints," he said. With mental illness, "a lot of anxiety manifests as chest pain."


Corinne Mattson said...

I feel that a lot of people will look at that story and think "why is that doctor ordering so many tests?" Clearly there is nothing wrong with them.

The problem that the Obama administration fails to realize is that without tort reform any big changes to healthcare won't work.

For example they cite heart problems in some of those patients. They probably all to some extent have real disease in some form. So, the guy that had a prior MI and now has a stent comes in with chest pain. It is is third visit this week. Obviously it is most likely not his heart causing the current problem. However in a court of law it doesn't matter that this guy has been seen 100 times after his heart attack with nothing wrong if on his 101st visit he has another big MI. Could you imagine yourself on cross-examination..."doctor this patient has a history of coronary artery disease with prior stenting, he came in with chest pain, all you did was an EKG, is that the standard of care?"

Well, no it isn't, but this guy always comes in with that complaint and it never is his heart. I screened him and didn't think anything new was going on. Too bad Mr. ER doctor. Get your check book out and start writing.

That is the underlying problem. There is no medicolegal backup for me trying to nickel and dime that patient. All I can potentially do is lose. Therefore, I will check all the labs that I know will be normal and admit him to the hospital so I'm not the last guy holding the chart when he has the big one.

Very frustrating. Americans rely on their ability to sue, in the same breath they then complain about the 500 dollar ER visit. Who do you think pays for Mr. Johnsons $500,000 lawsuit?

Travis said...

Amen, brother.