NYU Emergency department VIP issues

[Boatswain2PA]

He could come to the states!

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[benem]

What is wrong with direct admission to the hospital?

Direct admissions can be inappropriate if the patient isn’t actually stable. For example, we had a VIP patient direct admitted with chest pain from an internists office. That patient should be managed in the ER.

 

[johnny_bananas]

It happens all the time in Canada too. If you know somebody you go to the top of the list. The have nots wait months to years for care

&amp#039;We know everyoneâs not equal&amp#039;: Queue-jumping probe looks at patients who receive VIP treatment

A wealthy patron cancelled his fast-tracked colonoscopy so he could go to the Calgary Stampede â and was put back near the front of the line

nationalpost.com

Canada's universal healthcare may not be so universal after all

Canada's universal healthcare may not be so universal after all

www.latimes.com

There is a massive difference in doing favours for friends that doesn’t jeopardize others healthcare from VIP treatment for the wealthy such as that mentioned in the NYT article.

The examples that are listed in the National Post article doesn’t even compare to the NYT article. These are some examples of VIP treatment in Alberta:

“In Calgary, nurses who helped run overburdened, public vaccination clinics during 2010’s H1NI pandemic described how they had ushered friends and family into the clinics during breaks to get their shots rather than wait in line. They argued the vaccine — which had a short shelf life once prepared for injection — would have been wasted otherwise.”

“Two hospital administrators said they were regularly asked by superiors to check in with VIPs who had been admitted, though one said she never did visit the prominent patients’ bedsides.”

This is the most egregious example listed in article:
"While most screening patients had to wait up to three years, clerks testified that clients of the private, fee-charging Helios Wellness Centre — located nearby on the U of C campus — got a scan in as little as a few weeks. The arrangement was set up to reward major donors to the university, one doctor told the inquiry.
There has been no evidence, however, that the private customers’ queue-jumping — as inappropriate as it would appear to be — actually meant patients who needed a scan quickly had to wait any longer. And from that perspective, the inquiry has unearthed little evidence that is deeply concerning, said Dr. Danielle Martin, head of the group Canadian Doctors for Medicare"

The above example is likely why a special commission was set up to investigate the matter. VIP treatment for the wealthy would be a direct violation of the Federal Canada Health Act.

The second article you attached provides no evidence of VIP treatment.

 

[turkeyjerky]

Since you mention it, I was actually talking to a Canadian recently who tore his ACL skiing. He said it would probably have been 6-12 months to get an MRI and see an Orthopedic surgeon, but he happened to have a friend of a friend of a friend who was the Ortho secretary and could bump him up the waiting list. Was he just completely full of it?

He was not complaining about this btw, just explaining how it worked.

Considering most people w/ an ACL tear will do fine w/ PT and don't actually need an MRI or a surgeon, I don't see what the problem is.

Big difference, imho, between letting a colleague skip the queue for an outpatient appt and clearing the trauma bay for a someone's papercut...

I'm honestly a little surprised by all the posts justifying or supporting NYU's behavior. This stuff seems to go well beyond the pale in terms of normal catering to fat cats. They had a f'ing notation programed into their EMR for chrissakes!

WTF is up with their lawyer denigrating their former docs?? Langone might have to cough up another 100M for the slander suits...

 

[emergentmd]

While most screening patients had to wait up to three years, clerks testified that clients of the private, fee-charging Helios Wellness Centre — located nearby on the U of C campus — got a scan in as little as a few weeks. The arrangement was set up to reward major donors to the university, one doctor told the inquiry.

So what is wrong with this? Anyone who thinks this is egregious should run a hospital system and try to get rid of VIPs privileges. You know you would be out of a job in about the time a phone call is made.

If I donated 10-100M to NYU and I asked for a CT scan, I better get it done on my schedule going in the back door with my own VIP parking spot 10 steps from the scanner. If NYU doesn't understand my benefit, I am sure another hospital system would love my 100M and buy me a room with my personal CT scanner that would costs about 2M.

Sorry, but 10-100M for a hospital system saves way more lives and improves outcome for many more people even if someone died waiting to get a CT scan. Someone dying is not the product of waiting but a broken system to manage critical care pts quicker.

 

[emergentmd]

. He said it would probably have been 6-12 months to get an MRI and see an Orthopedic surgeon

Off topic BUT this is why I would never want universal healthcare. Who wants to wait 12 months to get a MRI?

 

[Apollyon]

Y'all gotta look at this a bit more granularly. There are two kinds of VIPs - the first is people that keep society going, like the President or the Governor or the circuit court judge. The second are the people "famous for being famous" - the 10mil donor, the member of the foreign royal family, the film star, the musician. The first is MUCH more tolerable than the second.

However, there is a caveat, as the 10-100mil donor might, very likely, be strongly politically connected, and have an undue effect on those that would fall in the first category, so, the rich donor functionally moves from the second group to the first.

Twenty years ago, at Mt Sinai, the 11th floor was the "amenities floor", and you couldn't go there unless you had a legit reason. No residents on the floor, and, if you took the elevator there, they would stop you from getting off, if you didn't belong there. I haven't been back in about 13 years, but, I don't know if the lift is now badge controlled.

Oh, and, when I was a resident, there was a story that had reputedly occurred a "few years before" that a Middle Eastern royal family had a member as a pt. The entire wing of a floor was shut down. Part of the story was that they paid, completely, for the wedding of one of the nurses. But, the coda? Reportedly, what they didn't pay was the bill!

 

[Lexdiamondz]

The hospital is named NYU Langone. When Mr. Langone himself walks in as a patient I think it’s reasonable that he is a priority.

Let’s face it, we all do this with our families. How many of your families would wait 8-10 hours in a waiting room? No, you would ask the charge nurse to bring them back.

This is essentially the same thing.

Disagree.

I can't imagine any of us would demand to use the resus bay at the shops we work at, demand to be examined by the chief of orthopedics for an ankle fracture, or demand to skip a stroke code or trauma code in the line for CT.

Capitalism or not, we're talking about acute care physicians working at a nonprofit ER. These types of policies are unacceptable.

 

[Tiger26]

Every industry treats VIPs differently. Banks, hotels, airlines, restaurants, colleges all crater to VIPs preferentially. That's capitalism. The entire Mayo Clinic system is built on cratering to wealthy VIP patients. Hospitals need the money. NYU med school just went tuition-free recently. That money didn't come from nowhere.

I get irritated when VIP pts try to dictate care but that's nothing new.

Yes and no--Mayo has outpatient clinics and some other service lines in place that efficiently cater to the VIP crowd. With regard to emergency medicine, patients are treated on the basis of acuity. In the curtain-separating-room era as a resident in the ED, we had royalty/movie stars in beds right next to the intoxicated/homeless crowd and there was nothing expediting their care other than acuity.

 

[johnny_bananas]

So what is wrong with this? Anyone who thinks this is egregious should run a hospital system and try to get rid of VIPs privileges. You know you would be out of a job in about the time a phone call is made.

If I donated 10-100M to NYU and I asked for a CT scan, I better get it done on my schedule going in the back door with my own VIP parking spot 10 steps from the scanner. If NYU doesn't understand my benefit, I am sure another hospital system would love my 100M and buy me a room with my personal CT scanner that would costs about 2M.

Sorry, but 10-100M for a hospital system saves way more lives and improves outcome for many more people even if someone died waiting to get a CT scan. Someone dying is not the product of waiting but a broken system to manage critical care pts quicker.

So what is wrong with this?
The Canadian health care system is premised in part on the ideal of equitable access to necessary healthcare without regard to one’s ability to pay for those services - this ideal is coded in Canadian federal law.

If it was shown that a wealthy donor was obtaining preferential treatment for necessary healthcare, this is in violation of not only federal law but an ethical principle that Canadians take very seriously.

 

[johnny_bananas]

Off topic BUT this is why I would never want universal healthcare. Who wants to wait 12 months to get a MRI?

I am not suggesting that there aren’t major issues with Canadian socialized healthcare, a lack of an adequate budget for one that leads to increased wait times for certain investigations (i.e. MRI), but that is far better than the alternative and can be fixed by increasing the budget.

In a private system, what is the solution when an individual cannot afford healthcare? On a societal level this not only leads to worse outcome but increased cost, why Americans pay more for healthcare and get less.

Take the example of a 45yo with uncontrolled diabetes and hypertension that is uninsured and cannot afford medical evaluations or medications. On a societal level, does it make more sense to pay for their medical appointments and medications, or pay for a timely MRI and nursing care when they have a stroke?

 

[HemeOncHopeful19]

Take the example of a 45yo with uncontrolled diabetes and hypertension that is uninsured and cannot afford medical evaluations or medications. On a societal level, does it make more sense to pay for their medical appointments and medications, or pay for a timely MRI and nursing care when they have a stroke?

I mean I would advocate to pay for all of those things.

But with the caveat that they should pay us well for all of those things and not peanuts.

 

[EctopicFetus]

Non profit or not we know that’s nothing more than a tax designation. They all want to make money. Did anyone miss the ascension article. They have $55b and are running their own private equity style fund. Does this sound like something a non profit should be doing?
they all have to make money. If not salaries don’t get paid And nurses and docs and janitors and security don’t work for free.
being a non profit you need donations to help with big capital outlays. Mr langone is the source of this. I personally don’t care one but. Bring the vips. I’ll treat them. I don’t care.
my favorite story from my prior job which had a bunch of super high maintenance type rich patients. I took care of an older lady In her 70s for a nosebleed. I looked in her nose and bleeding had stopped. I told her so and she was happy with her care. I didn’t know who she was.
come to find out she had donated some money to the hospital before but wa so happy with my care (I literally did nothing) that she wanted to donate 30k to the hospital. i Mean it was kind of dumb.

 

[NYEMMED]

Disagree.

I can't imagine any of us would demand to use the resus bay at the shops we work at, demand to be examined by the chief of orthopedics for an ankle fracture, or demand to skip a stroke code or trauma code in the line for CT.

Capitalism or not, we're talking about acute care physicians working at a nonprofit ER. These types of policies are unacceptable.

I’m not talking about all of that.

No we would never jump a priority patient or use a resus bay unless needed. But majority of EM docs would ask the charge nurse to bring their person back over others with a similar acuity.
It happens all the time. Nurses get their people back. The CEO gets their people back etc…

 

[Saddleshoes]

It sounds like different levels of care based on who you are.
Instead of focusing on the top level of care, let's talk about the bottom level of care.
Can any of you say that you treat the "Public Aid" case exactly the same as the "Golden Insurance" case?

 

[Brigade4Radiant]

Or does a homeless person receive the same level of follow up as a person with insurance? Which impacts their health?

 

[Siggy]

It sounds like different levels of care based on who you are.
Instead of focusing on the top level of care, let's talk about the bottom level of care.
Can any of you say that you treat the "Public Aid" case exactly the same as the "Golden Insurance" case?

99% of the time I have zero clue about my patient's insurance status until it comes time for LTAC.

 

[dantt]

I wonder what arthur Kaplan thinks about this lol.

 

[Kryptocoin]

Yes and no--Mayo has outpatient clinics and some other service lines in place that efficiently cater to the VIP crowd. With regard to emergency medicine, patients are treated on the basis of acuity. In the curtain-separating-room era as a resident in the ED, we had royalty/movie stars in beds right next to the intoxicated/homeless crowd and there was nothing expediting their care other than acuity.

No one is advocating clearing out the ER for VIPs. I have treated lots of VIP pts in the ER. The difference is that the VIPs have all the specialists on board prior to their arrival in the ER. The homeless guy next to them doesn't have the chief of ortho or cardiology waiting for them on arrival. Those facts alone expedite care.

In fact, VIPs are the easiest ER pts to treat. I don't have to deal with multiple phone calls haggling with hospitalists and consultants. The homeless guy, on the other hand, can be a dispo nightmare.

 

[Cath Up]

Off topic BUT this is why I would never want universal healthcare. Who wants to wait 12 months to get a MRI?

There was a concerted effort in the aughts to convince people of delays like this in a single payer system like Canada, by lobbying groups in the US with vested interests in the status quo. It is largely made up.

 

[gro2001]

Mostly because the "nomenklatura" doesn't really have a high quality of life compared to American VIPs.

Yes, definitely. And the poorest of the poor weren't homeless.

 

[Boatswain2PA]

Yes, definitely. And the poorest of the poor weren't homeless.

If you remove the drug & psych problem in America then the same thing applies here.

Not many drug addicts living on the streets of China because it's not allowed.

 

[WilcoWorld]

If you remove the drug & psych problem in America then the same thing applies here.

Not many drug addicts living on the streets of China because it's not allowed.

You don't get to just set aside two of the biggest socioeconomic crises in a society when comparing social structures.

 

[emperor tamarin]

Non profit or not we know that’s nothing more than a tax designation. They all want to make money. Did anyone miss the ascension article. They have $55b and are running their own private equity style fund. Does this sound like something a non profit should be doing?
they all have to make money. If not salaries don’t get paid And nurses and docs and janitors and security don’t work for free.
being a non profit you need donations to help with big capital outlays. Mr langone is the source of this. I personally don’t care one but. Bring the vips. I’ll treat them. I don’t care.
my favorite story from my prior job which had a bunch of super high maintenance type rich patients. I took care of an older lady In her 70s for a nosebleed. I looked in her nose and bleeding had stopped. I told her so and she was happy with her care. I didn’t know who she was.
come to find out she had donated some money to the hospital before but wa so happy with my care (I literally did nothing) that she wanted to donate 30k to the hospital. i Mean it was kind of dumb.

I think you would care if you got fired because a vip was unhappy with your care even though it was perfectly appropriate. That sort of stuff happened at nyu. See the older thread about Dr. Carmody (she's in the article). Or if your job prospects as a resident where hurt by this kind of crap.

 

[gro2001]

If you remove the drug & psych problem in America then the same thing applies here.

Not many drug addicts living on the streets of China because it's not allowed.

People are mostly not homeless because of drug addiction. They are addicted to drugs because of homelessness (or other life catastrophes). If anyone needs alcohol and drugs to get through the day it's people who are going through stuff like that.

 

[Boatswain2PA]

You don't get to just set aside two of the biggest socioeconomic crises in a society when comparing social structures.

I'm not setting it aside.

Socialist/communist/authoritarian countries don't allow for drug addicts and mentally unwell to live out in the open like we have in past few decades. They throw drug users in jail (and sometimes use them to bargain for international arms dealers in other jails, but that's a tangent), and institutionalize the mentally ill.

So, if you are going to compare our mixed system with an authoritarian/socialist/communist system, then you either have to control for that difference, or ignore their outcomes in our system.

 

[Boatswain2PA]

People are mostly not homeless because of drug addiction. They are addicted to drugs because of homelessness (or other life catastrophes). If anyone needs alcohol and drugs to get through the day it's people who are going through stuff like that.

Might vary bypopulation. Around here most homeless got on the meth train, fried their brains, and are now homeless.

 

[gro2001]

Might vary bypopulation. Around here most homeless got on the meth train, fried their brains, and are now homeless.

I think it's tempting to think that that's a typical story. That way you can see a person like that and walk by without shuddering too much because you get to comfort yourself that this could never happen to you. Because after all, YOU would never do meth. But in reality that's just not the case.

 

[Boatswain2PA]

I think it's tempting to think that that's a typical story. That way you can see a person like that and walk by without shuddering too much because you get to comfort yourself that this could never happen to you. Because after all, YOU would never do meth. But in reality that's just not the case.

That is one way of viewing it, commonly taught in schools today.

The reality here is different. My experience in the ED, and with starting/running a nonprofit to help the poverty stricken shows that it is almost always the drugs (meth, heroine) first, then brain damage, then poverty, then homelessness.

 

[southerndoc]

People are mostly not homeless because of drug addiction. They are addicted to drugs because of homelessness (or other life catastrophes). If anyone needs alcohol and drugs to get through the day it's people who are going through stuff like that.

While probably technically correct in that the majority are not homeless because of drug addiction, a significant portion are. There are plenty of people in my area that are homeless because of drug addiction. Many aren't on the streets -- they live in their cars. A good portion of homeless have mental health conditions, many are addicted to drugs, some can't afford housing due to housing costs, some are just down on their luck. The reasons are multifactorial, but drug addiction does play a significant role in some locations for cause of homelessness.

 

[WilcoWorld]

That is one way of viewing it, commonly taught in schools today.

The reality here is different. My experience in the ED, and with starting/running a nonprofit to help the poverty stricken shows that it is almost always the drugs (meth, heroine) first, then brain damage, then poverty, then homelessness.

Is that why drug abuse and addiction drove Rush Limbaugh, Hunter Biden and Jordan Peterson into poverty and homelessness?

 

[WilcoWorld]

While probably technically correct in that the majority are not homeless because of drug addiction, a significant portion are. There are plenty of people in my area that are homeless because of drug addiction. Many aren't on the streets -- they live in their cars. A good portion of homeless have mental health conditions, many are addicted to drugs, some can't afford housing due to housing costs, some are just down on their luck. The reasons are multifactorial, but drug addiction does play a significant role in some locations for cause of homelessness.

Unquestionably, the problems are related, but the arrow of causality isn't unidirectional. These are multifactorial problems and mental health and drug use clearly impact wealthy Americans differently (on average) than it does poor Americans.

 

[Kryptocoin]

Is that why drug abuse and addiction drove Rush Limbaugh, Hunter Biden and Jordan Peterson into poverty and homelessness?

I won't compare those three men to the average guy. Jordan and Rush have a fan base that's willing to supply them endless streams of money to support their addiction. And Hunter Biden has well....his dad and his last name.

 

[WilcoWorld]

I won't compare those three men to the average guy. Jordan and Rush have a fan base that's willing to supply them endless streams of money to support their addiction. And Hunter Biden has well....his dad and his last name.

I'm not saying they're average guys. But they do demonstrate that there are more factors than drug abuse that determine social outcomes.

 

[anonperson]

People are mostly not homeless because of drug addiction. They are addicted to drugs because of homelessness (or other life catastrophes). If anyone needs alcohol and drugs to get through the day it's people who are going through stuff like that.

This new meth is frying people's brains so they can't function in a reasonable manner. This wasn't the case 15 years ago.

Even alcoholics could be somewhat functional. These meth addicts are something else.

 

[Boatswain2PA]

Is that why drug abuse and addiction drove Rush Limbaugh, Hunter Biden and Jordan Peterson into poverty and homelessness?

There is drugs (pot, benzos, nicotine, alcohol, opioids)opioid, and then there are DRUGS (meth, heroin, synthetic fent).

Limbaugh and Peterson were addicted to benzos (I believe). Biden had enough family resources (maybe part of the "10% to the big guy") to go through rehab several times (AND pay to import Russian hookers, etc).

Probably none of us here have those kind of resources.

 

[Boatswain2PA]

I'm not saying they're average guys. But they do demonstrate that there are more factors than drug abuse that determine social outcomes.

Yes, the kind of drug, and if your dad is one of the most powerful men in the world you can be forced into rehab enough times it might stick.

 

[BicepsTriceps]

There is drugs (pot, benzos, nicotine, alcohol, opioids)opioid, and then there are DRUGS (meth, heroin, synthetic fent).

Limbaugh and Peterson were addicted to benzos (I believe). Biden had enough family resources (maybe part of the "10% to the big guy") to go through rehab several times (AND pay to import Russian hookers, etc).

Probably none of us here have those kind of resources.

I would honestly add heavy alcoholism with DRUGS.

The worst cases of drugs destroying lives and bodies I've seen are mostly alcoholics.

 

[WilcoWorld]

There is drugs (pot, benzos, nicotine, alcohol, opioids)opioid, and then there are DRUGS (meth, heroin, synthetic fent).

Limbaugh and Peterson were addicted to benzos (I believe). Biden had enough family resources (maybe part of the "10% to the big guy") to go through rehab several times (AND pay to import Russian hookers, etc).

Probably none of us here have those kind of resources.

Yes, the kind of drug, and if your dad is one of the most powerful men in the world you can be forced into rehab enough times it might stick.

We know of drug addicts who are not homeless, and we know of people suffering from homelessness who are not drug addicts. This proves that drug use is neither a necessary nor sufficient condition for homelessness.

 

[Boatswain2PA]

We know of drug addicts who are not homeless, and we know of people suffering from homelessness who are not drug addicts. This proves that drug use is neither a necessary nor sufficient condition for homelessness.

The same could be said about any condition. People who have had strokes are neurological intact; who have had STEMI's have 60% EFs, etc ad nauseum.

There is not 100% correlation (let alone causation) between (bad) drug use and homelessness.

But that doesn't mean most homelessness isn't caused by drug use.

Especially in some areas.

 

[WilcoWorld]

The same could be said about any condition. People who have had strokes are neurological intact; who have had STEMI's have 60% EFs, etc ad nauseum.

There is not 100% correlation (let alone causation) between (bad) drug use and homelessness.

But that doesn't mean most homelessness isn't caused by drug use.

Especially in some areas.

I think I understand your point, please correct me if I'm wrong:

You're saying that most homelessness is caused by drug abuse (especially in some areas). And, because drug use is a choice, homelessness is the fault of the homeless (especially in those aforementioned areas).

 

[WilcoWorld]

The same could be said about any condition. People who have had strokes are neurological intact; who have had STEMI's have 60% EFs, etc ad nauseum.

There is not 100% correlation (let alone causation) between (bad) drug use and homelessness.

But that doesn't mean most homelessness isn't caused by drug use.

Especially in some areas.

I disagree that the same can be said for all conditions.

You can't have brain herniation without increased ICP. You can't have a bowel obstruction without obstructed bowel. You can't have drug addiction without drugs. Those are necessary conditions.

You will have death if you have decapitation. You will have renal failure if you have no fluid intake for >2 weeks. You will have infection if you don't wash out a grossly contaminated open fracture. Those are sufficient conditions.

 

[NYEMMED]

It sounds like different levels of care based on who you are.
Instead of focusing on the top level of care, let's talk about the bottom level of care.
Can any of you say that you treat the "Public Aid" case exactly the same as the "Golden Insurance" case?

Yes because I have no idea what their insurance is. So everyone gets treated the same.

Most ER docs never know what insurance their patient has or doesn’t have

 

[miacomet]

The same could be said about any condition. People who have had strokes are neurological intact; who have had STEMI's have 60% EFs, etc ad nauseum.

There is not 100% correlation (let alone causation) between (bad) drug use and homelessness.

But that doesn't mean most homelessness isn't caused by drug use.

Especially in some areas.

Lol rich druggies aren't homeless, neither are rich drunks.
There are drug users in every country. Yet in other countries many of them are housed...seems like the cause of homelessness might not be drug use, but social policies towards non rich drug users.

 

[southerndoc]

How did this topic get derailed from VIP treatment at NYU Lagone into discussion of the causes of homelessness?

 

[WilcoWorld]

How did this topic get derailed from VIP treatment at NYU Lagone into discussion of the causes of homelessness?

Because, Communism.

 

[EctopicFetus]

I think you would care if you got fired because a vip was unhappy with your care even though it was perfectly appropriate. That sort of stuff happened at nyu. See the older thread about Dr. Carmody (she's in the article). Or if your job prospects as a resident where hurt by this kind of crap.

There is almost always more to the story than just a vip being unhappy. Let’s be real. I’ve pissed off a number of people in my day. Never once felt like my job was even remotely in jeopardy. Also with an SDG I know my people have my back. Your job prospects only get hurt in EM if you have an issue with your pd. The ceo of my current hospital and where I trained don’t know the names of any residents. Also never heard of a job saying hey I want to talk to the hospital ceo about you.
as a doc we have to understand the hospital ceo runs the show. If they want some idiot friend of theirs brought back go and do it. Recently, I took care of some vip at my hospital. Was fairly comical in its simplicity. Old rich white lady fell. Sent for a head Ct. i did my bit. Spent less than 2 mins in the room. Ct ordered. Plastics (who I don’t think I ever saw in the Ed) then shows to suture this old lady. She wasn’t the nicest. I didn’t care one bit. 2 mins of my time for a simple case. Patient was happy. As someone said above in a lot of ways these cases are the easiest.
imagine same old lady showing up with small facial lac and starting with the “I want to see a plastic surgeon”. That is the crap that used to really jack up my day. Here the lady gets what she wants. I get the RVUs for a simple and low risk case.

 

[emperor tamarin]

There is almost always more to the story than just a vip being unhappy. Let’s be real. I’ve pissed off a number of people in my day. Never once felt like my job was even remotely in jeopardy. Also with an SDG I know my people have my back. Your job prospects only get hurt in EM if you have an issue with your pd. The ceo of my current hospital and where I trained don’t know the names of any residents. Also never heard of a job saying hey I want to talk to the hospital ceo about you.
as a doc we have to understand the hospital ceo runs the show. If they want some idiot friend of theirs brought back go and do it. Recently, I took care of some vip at my hospital. Was fairly comical in its simplicity. Old rich white lady fell. Sent for a head Ct. i did my bit. Spent less than 2 mins in the room. Ct ordered. Plastics (who I don’t think I ever saw in the Ed) then shows to suture this old lady. She wasn’t the nicest. I didn’t care one bit. 2 mins of my time for a simple case. Patient was happy. As someone said above in a lot of ways these cases are the easiest.
imagine same old lady showing up with small facial lac and starting with the “I want to see a plastic surgeon”. That is the crap that used to really jack up my day. Here the lady gets what she wants. I get the RVUs for a simple and low risk case.

I think you need to go read that carmody lawsuit, and then come back. I don't feel like looking for the link for you but it was on this forum and others. It pretty clearly outlines the csuite of NYU specifically going after her for vip care stuff. And then some major changes in nyus dept of em, at the behest of the csuite, which led to the acgme complaint and the program going on probation.
Yes there are 2 sides to every story, but I don't find the NYU denials in the NYTimes story remotely believable or credible ("there is no VIP care at NYU, yada yada" from the cmo quoted in the article followed by screenshots of flags on charts for trustees and confirmation of special trustee phone lines etc).
It's exceptionally rare that a program goes on probation. There are 2 in all of em. This is not your usual situation as you are describing it.

 

[Gastrapathy]

There was a concerted effort in the aughts to convince people of delays like this in a single payer system like Canada, by lobbying groups in the US with vested interests in the status quo. It is largely made up.

My family experience was that these delays are real. Family member waited a long time for a cataract surgery. Had a complication that required reoperation and went to the back of the line and waited again. Getting him a cardiologist was also impossible and he obviously needed a pacemaker. He had plenty of money and could have driven an hour south and got it done but he had way too much pride in the superior Canadian system to consider that. So…not sure it’s all marketing and I only have anecdotes but I do have a few more about other relatives and cancer care delays etc.

 

[southerndoc]

I think you need to go read that carmody lawsuit, and then come back. I don't feel like looking for the link for you but it was on this forum and others. It pretty clearly outlines the csuite of NYU specifically going after her for vip care stuff. And then some major changes in nyus dept of em, at the behest of the csuite, which led to the acgme complaint and the program going on probation.
Yes there are 2 sides to every story, but I don't find the NYU denials in the NYTimes story remotely believable or credible ("there is no VIP care at NYU, yada yada" from the cmo quoted in the article followed by screenshots of flags on charts for trustees and confirmation of special trustee phone lines etc).
It's exceptionally rare that a program goes on probation. There are 2 in all of em. This is not your usual situation as you are describing it.

Carmody v. New York University et al (1:21-cv-08186), New York Southern District Court

Carmody v. New York University et al (1:21-cv-08186), New York Southern District Court, Filed: 10/04/2021

www.pacermonitor.com

For those without access, the actual complaint is also available from this Twitter feed (click to read the feed, then you'll see it stored in Dropbox):