Geriatric ER?

[Redrox]

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http://www.nytimes.com/2012/04/10/n...rgency-units-opening-at-us-hospitals.html?hpw

You all heard of this?
No hospital I've been in s'been posh enough for such pricey marketing gimic, yet. Just curious if you all have run in to any in your neck of woods.

 

[deleted109597]

No, but the comments make me laugh, then make me mad, then made me realize why the public doesn't understand the concept of emergency.

 

[Arcan57]

One of the hospitals in our system has a dedicated geri ED. It's in a somewhat disadvantaged part of town, so I think it makes sense because you know they are going to have a payor.

 

[8654Marine]

Intriguing yet so troubling.

I suspect that, for geriatric patients, a stubbed toe, a hangnail, or diarrhea would yield a heart condition.

Follow the money.

 

[docB]

One of the hospitals in our system has a dedicated geri ED. It's in a somewhat disadvantaged part of town, so I think it makes since because you know they are going to have a payor.

This. We have one at my hospital.

 

[RustedFox]

We don't have a dedicated geri-ED, but one shop in my city does.

Only thing that's different is the color of paint on the walls, and maybe a nice framed picture or two.

 

[DeadCactus]

Heard about it a few months back somewhere. Makes sense to me, we already have pediatric EDs...

 

[Hamhock]

Heard about it a few months back somewhere. Makes sense to me, we already have pediatric EDs...

This got me thinking about making the ED more profitable and dealing with EMTALA.

Instead of splitting the ED into peds, critical, geri, etc -- split into all-comers, self-pay, insurance, medcaid, etc?

All services -- including that MSExam -- are available to everyone, but there is only five beds and austerity for the no-pays who aren't critical and 100 beds with butlers for the rich folk.

I'll admit, this goes against my view of emergency medicine, but it seems pretty consistent with a lot of private medicine. This is done with all other specialties, just not emergency medicine.

HH

 

[docB]

This got me thinking about making the ED more profitable and dealing with EMTALA.

Instead of splitting the ED into peds, critical, geri, etc -- split into all-comers, self-pay, insurance, medcaid, etc?

All services -- including that MSExam -- are available to everyone, but there is only five beds and austerity for the no-pays who aren't critical and 100 beds with butlers for the rich folk.

I'll admit, this goes against my view of emergency medicine, but it seems pretty consistent with a lot of private medicine. This is done with all other specialties, just not emergency medicine.

HH

I hear you but it won't work. Once it became clear that you were providing different services or availability based on insurance status you're done.

 

[Hamhock]

I hear you but it won't work. Once it became clear that you were providing different services or availability based on insurance status you're done.

Yeah, I know that in some ways I am preaching to the choir and pointing out the obvious at once: but maybe a move like I described would highlight how we are the only specialty that sees everyone equally.

Every other specialty - whether they admit it or not - segregates patients into haves and have-nots.

Indeed, that is pretty much what the entire public hospital system was based on way back when (and still is, to a lesser extent).

As long as the ED is offering MSE and meeting EMTALA obligations (none of which demand the highest level of care; fastest care; or even EQUAL care), then there shouldn't be a legal challenge.

It would be interesting if some private shop keep their current ED as is - in both a physical and functional sense - but built an adjacent wing and called it the "acute care ED" (similar to the "pediatric ED" or "geriatric ED") and then filled it with paying patients...not advertised that way, just de facto...kind like a segregated geriatric ED.

HH