ER Bashing

[allendo]

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So I work in a small town of about 36k people at a level 3 trauma facility. I'm one of very few BE/EM docs in the region. The local Ortho group recently decided to open up a Ortho Urgent care. Thats fine and dandy but they have commercials on TV/Radio bashing the local ERs and the Docs. They blatantly state that the ER doctors do not know how to manage orthopedic injuries and to avoid the ER at all cost and come to their clinic. The relationship with this group of docs has always been healthy, despite them being paid 2k/day to take call when no one else gets paid to take call, and we always reduce all of their fractures and refer out to them. In my four years at the facility I've not seen one of them in the department for a fx we couldn't manage. What if anything should we do or say about this? The directors opinion is that we stop doing all of their reductions in the ED and call them in since they are getting paid for call anyway?

 

[winkleweizen]

I kind of agree with the director. That sounds like bs

 

[allendo]

It just feels like a slap in the face. Especially since they have complemented us multiple times on fx reductions that followed up with them.

 

[deleted547339]

That's garbage. I would discuss this with the ED medical director and possibly hospital admin. They may be bashing the ED, but by extension they are bashing the hospital.

 

[Brigade4Radiant]

So I work in a small town of about 36k people at a level 3 trauma facility. I'm one of very few BE/EM docs in the region. The local Ortho group recently decided to open up a Ortho Urgent care. Thats fine and dandy but they have commercials on TV/Radio bashing the local ERs and the Docs. They blatantly state that the ER doctors do not know how to manage orthopedic injuries and to avoid the ER at all cost and come to their clinic. The relationship with this group of docs has always been healthy, despite them being paid 2k/day to take call when no one else gets paid to take call, and we always reduce all of their fractures and refer out to them. In my four years at the facility I've not seen one of them in the department for a fx we couldn't manage. What if anything should we do or say about this? The directors opinion is that we stop doing all of their reductions in the ED and call them in since they are getting paid for call anyway?

Wow ortho is amazing the only group that gets paid for call.

 

[Birdstrike]

So I work in a small town of about 36k people at a level 3 trauma facility. I'm one of very few BE/EM docs in the region. The local Ortho group recently decided to open up a Ortho Urgent care. Thats fine and dandy but they have commercials on TV/Radio bashing the local ERs and the Docs. They blatantly state that the ER doctors do not know how to manage orthopedic injuries and to avoid the ER at all cost and come to their clinic. The relationship with this group of docs has always been healthy, despite them being paid 2k/day to take call when no one else gets paid to take call, and we always reduce all of their fractures and refer out to them. In my four years at the facility I've not seen one of them in the department for a fx we couldn't manage. What if anything should we do or say about this? The directors opinion is that we stop doing all of their reductions in the ED and call them in since they are getting paid for call anyway?

I would first have the director place a call to their director politely asking them to stop running the ad, while reminding them all the ER does to help them out, 24/7/365. If they do, then problem solved. If they don't, then proceed to go nuclear by making their life hell in every way possible.

The 3 am, "Hey, got a 90 yr old who when he farts has pain radiating to the hip. I don't feel comfortable not having a top notch ortho involved. Bring your A-game."

Then the 4 am, "Sorry, need you to come in for a shoulder dislocation."

As soon as they get home, boom! "Hey, needya back here for a non-displaced distal radius. I don't feel comfortable with a non-orthopedist placing a splint."

One of the good things about the ER is you have absolute power to make on-call docs' lives absolutely miserable, if you want to.

Give fair warning, then respond as indicated.


Or...the optimist's approach could be taken. Hope they run the ad 10 times per day so you might actually get to take a grump or throw down a pop tart and a Gatorade once in a while on a shift, if needed.

 

[Cerberus]

That's garbage. I would discuss this with the ED medical director and possibly hospital admin. They may be bashing the ED, but by extension they are bashing the hospital.

Agree, by bashing the ER, they are making the hospital look bad and causing a decrease in revenue. If I were hospital admin, I would ask them to stop/change the ad or face losing admitting rights and possible breach of contract. I personally wouldn't bother with the petty BS consults (although you can bet I wouldn't be doing any more courtesy reductions, and when they did show up, they'd be waiting till I'm ready to do sedation, which may be after I see the next few patients in my queue

 

[dotcb]

It's a shame your group would have to deal w/ unprofessional behavior like this by colleagues. I would have chief of your dept work w/ hospital leadership and the ortho group to have the ad removed or changed. I would try to solve the problem w/ goal of preserving relationship since all of you will need to keep working together..

 

[Doctor Bob]

I think they should see all of the chronic back pains with new exacerbations, or post low-speed MVC back pain/neck pain.
Refuse to take them in transfer unless the orthopedist rides with them in the ambulance.

 

[Groove]

Have your dir elevate this to hospital admin and your CMO. By running the ad, it infers substandard care in the ED (provided by the hospital) and is a disincentive for patients to proceed to the ED for care (orthopedic injuries or otherwise). It also raises medmal risk since pts who have seen the ad arrive automatically expecting poor quality care. Your dir could also let hospital admin know their concerns and that the new policy going forward if the ad is not changed is to consult for every orthopedic injury and bedside ortho consults in the ED for all fracture reductions based on above.

Let your hospital admin fight the battle and definitely involve them as they will have much more clout in dealing with the local ortho group. Hospital admin will be none too happy and if the ortho group wants to retain privileges, they will likely be pressured to change it fairly rapidly. I would avoid a simple ED vs local ortho group battle between directors or nasty 3am consult tactics with yelling and chart jousting. Have a firm ED policy implemented with the support of hospital admin if they can't pressure the group into changing the ad.

 

[oldanddone]

In my jurisdiction (canada) advertising and especially promoting oneself over another is considered unprofessional and gets in hot water with the college. Wonder if there is a possible angle there to have them think about and reconsider their ads.

 

[Old_Mil]

Option 1: Have your ED medical director and ED director request a meeting with the C suite and let them know that they are running an ad slamming the hospital.

Option 2: Unless you are an RVU shop realize that some people are goung to see the ad and avoid your department resulting in lower volumes and better metrics for you.. Tell them how happy you are that they opened that urgent care and are advertising it.

Sent from my awesome Ubuntu device using the Forum Browser app

 

[gman33]

I'd have to hear the ad to comment on what I think it means.
If you are marketing a product, you need people to think it's better than the alternative.

It's going to be hard to win a pissing match with a consultant that brings in tons of $$$ to your hospital.
Even if they are now stealing away some ER patients, the hospital likely makes a lot of money off these guys.

As long as the ortho group provides good service to me when I call, I'd just keep my mouth shut on this one.