I think it’s impossible to practice EM without eventually getting this way, once in a while. I’ve been there.
It's like this in every field. I had one bad fuucking day. A single bad day. All the other 364 days I'm fine and these patients I have a very neutral interaction with them because they are easy dispos.
Cardiologists have bad days.
Anesthesiologists have bad days
Oncologists have bad days.
ENTs have bad days.
I'll say this:
- it was 100% not right for that mom to bring in her daughter, after having a fever for 2 hours, to the most expensive place on this earth for an evaluation. If she is going to live in America then she has to learn how stuff works here. It's not "her fault", she wasn't malicious, she wasn't malingering, she isn't trying to game the system. But I contend that there are better trained doctors for a 2 hr fever in a well child. I would also contend that she has pretty poor general knowledge about health and it's embarrassing but she is a product of whatever educational system she grew up in and her culture. It's NOT HER FAULT.
- ER's in hispanic countries like Mexico and central america cost money for all patients. Mothers who have a daughter with a fever for 2 hours don't go to the ER's in Mexico because it COSTS MONEY. They usually go to the pharmacy and the pharmacists recommends tylenol or an antibiotic or whatever
- FREE SHIIIT IN SOCIETY IS ABUSED! 100% why is that so hard to believe
- it is 100% our job to educate people on the appropriate use of the ER. It's 100% our job to tell them what we are capable of doing. I think it should be done non-condescendingly, and I admit that on that day I was kind of a jerk to both those patients. But I ALWAYS EDUCATE people on what we do in the ER. All the fuucking time. Because I don't work up a lot of their nonsense even if the PCP's send them in.
- There are people who abuse the ER and they need to be called out
- There are people who don't know any better and come in for dumb stuff and we should politely teach them what the ER can and can't do. There is no shame in that.
- We TEACH AND WE EDUCATE PEOPLE ALL THE TIME.
- It used to bother me to write tylenol Rxs...but as I've matured now I don't care. it takes 5 second for me to write one. If a mother or father wants to wait 4 hours in an ER to save $5, then fine.
- I philosophically am at odds with others who think the ER is the safety net for all the uninsured, forlorned, homeless, etc. It is my job to render EMERGENCY CARE and not HEALTH CARE to the uninsured. It's not my job to figure out how homeless is going to afford, acquire, or dose their insulin. If the government wants ERs to do primary care for the uninsured...then the US government can talk to the ER RRC to change how we are trained, or pay us to do it, or they can eek! pass a law that ERs are supposed to deliver primary care to anyone who comes into the ER.
- THERE ARE FREE CLINICS for MEDICAID patients IN THE SAME CITY THAT I WORK. Free!
---- all of you people out there...have you ever had a teacher growing up who just once got really frustrated with you? Just once? Like in 4th grade math, 8th grade social studies, or 11th grade history? JUST ONCE?