How do we fix this?

[NSAIDAllergy]

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http://www.foxnews.com/story/0,2933,337295,00.html

 

[TakayaSue]

"Every patient who comes to the emergency department is a failure of the public health system," Goldfrank said. "Many of the patients have chronic diseases that are monitored and treated at the outpatient clinic."

That sounds like a sweeping generalization. I didn't know every case of appendicitis was preventable. Maybe I should start reading that toxicology textbook with a more critical eye... I mean, c'mon Dr. Goldfrank! 🙄

But seriously, though. Boarding, crowding, and diversion are huge issues. Mad props to Jesse Pines, whose data (among others) were what Linda Lawrence was quoting in terms of the measurable clinical impact of crowding. Now we need to get CMS and JCHAO on board, making these costly activities for hospitals.

 

[pseudoknot]

Now we need to get CMS and JCHAO on board, making these costly activities for hospitals.

Oh yes, they'll fix everything! With no unintended consequences whatsoever!

 

[EctopicFetus]

Ill be the first to say a lot of the public health stuff is run by the people who lie to the furthest to left of all people medical or otherwise. Lots of apologists IMO.

 

[EM_Rebuilder]

Who is this guy?

"Dr. Brian F. Keaton, chairman of the board of directors of the ACEP, practices emergency medicine in Akron, Ohio. His story illustrates the situation faced by many doctors.

"I have people who come to my clinic with a headache caused by high blood pressure. I give them the medicine to bring the blood pressure down and a prescription," Keaton said in an anguished tone."


Does this guy really exist, and if so, what is this 'my clinic' he speaks of??


This one gets me too..

"— In Houston, Texas, the average rate of diversion was 14 percent in 2001. Today, the rate is 40 percent, said Dr. Guy Clifton, a professor of neurosurgery at the University of Texas in Houston."

I wonder what the NSers would say if a quote said "-- In Jackson, MS over 90% of back surgeries end with worse pain than before, said Dr Boss, a professor of Emergency Medicine at Blah blah"

 

[pseudoknot]

Oh come now, I think it's pretty well established that there is a bit of a crisis in ED capacity. EF, I don't see this as a partisan issue, and hell, the article was in Fox News. I did notice the diversion quote being from a neurosurgeon and thought it was a little odd, but the number is believable. I agree they should have gotten an EP to comment instead.

However, I don't think talking about diversion and poor spinal surgery outcomes are equivalent. Who's saying it's the EPs' fault that the system is so overloaded? No one I know.

 

[GeneralVeers]

Oh yes, they'll fix everything! With no unintended consequences whatsoever!

Don't forget the unfunded mandates!

 

[Dr. Dukes]

Don't forget the unfunded mandates!

Why, making us do something and then not paying us for it, that can't go poorly at all, can it?

 

[MaxDesMer]

Who is this guy?

"Dr. Brian F. Keaton, chairman of the board of directors of the ACEP, practices emergency medicine in Akron, Ohio. His story illustrates the situation faced by many doctors.

“I have people who come to my clinic with a headache caused by high blood pressure. I give them the medicine to bring the blood pressure down and a prescription,” Keaton said in an anguished tone."


Does this guy really exist, and if so, what is this 'my clinic' he speaks of??


This one gets me too..

"— In Houston, Texas, the average rate of diversion was 14 percent in 2001. Today, the rate is 40 percent, said Dr. Guy Clifton, a professor of neurosurgery at the University of Texas in Houston."

I wonder what the NSers would say if a quote said "-- In Jackson, MS over 90% of back surgeries end with worse pain than before, said Dr Boss, a professor of Emergency Medicine at Blah blah"

Although I agree with the premise of the article, it provided a tremendous sensationalistic flavor when it added these quotes and infomation from 2000 to support its claim. Seriously, how does a neurosurgeon know anything about diversion rates???? The author could have at least qualified that.

 

[iridesingltrack]

Interesting but brief article addressing what I see as a major problem that emergency medicine must face. Sensational. Yes. But, I submit that that was appropriate. Maybe I'm wrong, but I don't think the general public yet appreciates the magnitude of the problem of ED overcrowding and boarding and how it may affect them or their family; an article like this gets the message out to the lay public. Which I think is good as it leads to discussion, like here, and hopefully some improvements.

As to Dr. Goldfrank's quote, I'd have to say that while dramatic I think that he is more right than wrong. In my limited experience it seems that the majority of ED visits are indeed public health failures. Think about trauma...I'd argue that each one is preventable whether through education, engineering, or law enforcement...not to mention behavior. HTN emergencies, ACS, CVA are examples of medical problems seen daily in the ED that follow predicatable patterns with known risk factors that can be modified and are therefore appropriate for "public health" interventions.

I too think it odd that Guy Clifton's (neurosurgeon) quote was included. Though, he has done substantial amounts of neurotrauma research, hypothermia for brain injury, which has probably exposed him to lots of EM issues; still seemed out of place though. 🙄

Just my .02

 

[Annette]

I think the ED in my hospital has had at least one patient being borded everyday since last Nov. We simply do not have enough beds or nursing staff. The current physical plant needs to be imploded and started all over again. But there is no money for this. Why? Same reasons the ED is overcrowded! Talk about chasing your tail.

 

[gutonc]

http://www.foxnews.com/story/0,2933,337295,00.html

Stop reading Fox News is a good start.

 

[EM2BE]

Stop reading Fox News is a good start.

Also getting the rest of the world to stop reading it would help. (Oh, I mean false news is still the truth right?)

 

[EctopicFetus]

Here is a snipet on the NSGeon..

He is active in this issue..

http://publicaffairs.uth.tmc.edu/media/newsreleases/nr2006/clifton_washington.html

Also if the government would have paid better for ED care so many of them wouldnt have closed and this would have been less of an issue.

 

[RockfordWF]

Also getting the rest of the world to stop reading it would help. (Oh, I mean false news is still the truth right?)

It sure is better to listen to Fox News than listen to the lies produced by the liberal media. (See New York Times.)

 

[pseudoknot]

It sure is better to listen to Fox News than listen to the lies produced by the liberal media. (See New York Times.)

I think it would be well for people to consider refraining from injecting their political views unnecessarily into discussions here...I have my own views on Fox News but I only commented on the content of the story because I didn't think my politics were relevant. Comments like the above can make the forum seem much more hostile and partisan than it needs to be (and I'm sure that wasn't your intention Rockford, we all have things we are passionate about!).

Just my opinion.

 

[grEMreapin]

It sure is better to listen to Fox News than listen to the lies produced by the liberal media. (See New York Times.)

Nevermind the countless lies produced this completely incompetent administration (see every time Dick/Bush opens its mouth). Slow thinkers, please keep right.

 

[enfuegoEP]

Here is a snipet on the NSGeon..

He is active in this issue..

http://publicaffairs.uth.tmc.edu/media/newsreleases/nr2006/clifton_washington.html

Also if the government would have paid better for ED care so many of them wouldnt have closed and this would have been less of an issue.

Nice work EF 😀

Let's try to keep this forum a "no spin zone"

 

[189362]

Stop reading Fox News is a good start.

I agree.