Can I Get An MRI?

[VA Hopeful Dr]

---

Members don't see this ad.

Sure, that's great in theory, but how is a patient supposed to know their condition isn't an emergency? Also, would a C-section be considered catastrophic? I doubt it. What about elective surgeries that while not emergently or urgently necessary, are important for the morbidity or mortality of the patient? Sure all of those would be cheaper, but still cost a couple thousand dollars.

By calling their PCP and asking. Catastrophic plans are basically high deductible plans. Pregnancy + delivery will reach that deductible as will pretty much any surgery that requires an OR.

 

[VA Hopeful Dr]

I wonder, if catastrophic insurance plans became the norm, would you guys be willing to change the SOP of your staff to send patients to the ER whenever they call in with a new complaint?

Plenty of people abuse the system, but everyday I see at least 2-3 reasonable people w/ nonemergent complaints who start off with, "well I really didn't think it was that serious, but I called my doc and the nurse told me that I had to come in right away".

Yeah, its a symptom of the current broken system. If you get bored (I know, a bored resident might as well be a unicorn), google Direct Primary Care. There is a group doing that in Washington State that partnered with an insurance company to see if the model could cut ED visits/costs. http://stateofreform.com/news/indus...e-primary-care-model-saves-20-percent-claims/

Not surprisingly, big cost savings and reduced ED visits.

 

[GeneralVeers]

Most people are too stupid to understand what an emergency is. That is why an MSE process is necessary. Within 30 seconds of talking to a chronic pain, sore throat pt, etc I can tell it's not an emergency even without any kind of exam.

I work an HCA hospital where we have this process, and I use it on 1-2 patients per shift. Once through the MSE process the patient has the option to leave, or pay out of pocket and be seen. I haven't had one person decide to be seen yet.

 

[Birdstrike]

I work an HCA hospital ...

 

[GeneralVeers]

They aren't that bad. Pretty much every hospital administration is the same now - a mixture of benevolent ignorance and corporate insanity. Although our HCA door-to-doc metric of 10 minutes is insane and unreasonable.

 

[Birdstrike]

They aren't that bad. Pretty much every hospital administration is the same now - a mixture of benevolent ignorance and corporate insanity. Although our HCA door-to-doc metric of 10 minutes is insane and unreasonable.

I love this post.

We've gotten to the point that a mixture of "benevolent ignorance," "corporate insanity," "unreasonable," and metrics that are "insane," now fall in to the category of "Not That Bad."

Hell, who needs "Bad" if "Not-That-Bad" is this bad? Lol

But whatever, right? It pays the rent, I suppose.

 

[Rendar5]

They are that bad and while I will work part time at an hca I will never work full time for one if I can help it. I will also avoid their emergency rooms if I can help it. They're among the more morally bankrupt practices I know of.

 

[Rendar5]

That said I did appreciate the MSE process for those that were nice but too dumb to know what actually needed an ER visit to treat

 

[GeneralVeers]

That said I did appreciate the MSE process for those that were nice but too dumb to know what actually needed an ER visit to treat

Exactly. I explain to them that I don't think they have a medical emergency and I would hate for them to have a "large bill from the hospital for nothing". I have my scribe do the chart, I get RVU credit for it, and the patient disappears.

 

[GeneralVeers]

I love this post.

We've gotten to the point that a mixture of "benevolent ignorance," "corporate insanity," "unreasonable," and metrics that are "insane," now fall in to the category of "Not That Bad."

Hell, who needs "Bad" if "Not-That-Bad" is this bad? Lol

But whatever, right? It pays the rent, I suppose.

As long as the bills are paid, I don't even care about the hospital environment any more. There is no green grass any more, just shades of brown covered in **** everywhere.

 

[Birdstrike]

As long as the bills are paid, I don't even care about the hospital environment any more. There is no green grass any more, just shades of brown covered in **** everywhere.

Lol. When you were a pre-med, did you know that down the road you'd being viewing your surroundings as a turd-mine field?

 

[Arcan57]

Couple of things:

1) I can't get into see a doctor after waiting only 10 minutes in any setting without pulling the "I'm a doctor" and calling the practitioner personally prior.

2) People's understanding of what will and won't happen after an MRI (or other advanced imaging/diagnostic procedures) is astonishingly inaccurate. They come in because something is hurting, act like you kicked their dog when you mention conservative therapy/PT, and are convinced that an emergent MRI will lead to surgery that day (or tomorrow at latest), and the surgery will take their pain away immediately without need for any lifestyle modification or significant side effects/ recovery time. While they make bank, I don't envy the spine surgeons that actually take the time to make people understand what surgery will and won't accomplish and what the post-op recovery/rehab is like.

 

[GeneralVeers]

Lol. When you were a pre-med, did you know that down the road you'd being viewing your surroundings as a turd-mine field?

No, but when I was pre-med 15 years ago the medical system was a much different place than now.