Moving in the wrong direction

[Octagonecology]

---

Members do not see this ad.

http://www.news-journalonline.com/NewsJournalOnline/News/Local/newEAST01070509.htm

Although Volusia County, FL has the most progressive free primary clinic system for the un-insured/poor, etc. It goes largely un-used and is wraught with no-shows and poor compliance.

Now in response to this, the clinics will just send everyone to the ER.

Hooray for progress.

 

[EC3]

As long as EMTALA's mandates exist, this problem isn't going to get solved.

As a general rule, people don't like to wait for anything and they don't like filling out forms or having to perform actual work to get services. This is especially true of the demographic that the above services are geared toward. The ER represents a much faster and easier option than any clinic ever will. Even if they wait 12 hours, it's still much faster when you consider that all labs and imaging will be done on-site; and they don't even have to go through the hassle of making an appointment or filling out any special paperwork, etc. Plus, since they don't pay anyway, there's no financial disincentive.

Until ER's can refuse to see non-emergent complaints, this problem will exist because there's always a more appealing option available than any clinic system, even if free. This is no different than having a very loose unemployment system and then wondering why people aren't finding jobs. So as long as the ER is mandated to see all complaints regardless of their nature, there's no reason to expect that someone will wait several days for an appointment and then follow up outpatient labs/imaging when they know that it won't cost them any more to wait several hours in the ER and get it all done there in a single visit. I think this shouldn't surprise anyone.

 

[Apollyon]

This is the segment of the patient population who want everything for nothing, immediately. Everything - all tests and exams, for nothing - no money, and trivial complaints, immediately - no appointment, and insisting that the trivial complaint be addressed posthaste.

The hospital system that I just left had begun a primitive program in the same vein for people with multiple visits for trivial complaints (that were not MedicAid). They would get the medical screening exam, and then the doctor would leave, and the financial counselor would come in and ask for $100 or $150 or whatever. If they chose to pay it, they would then be seen as regular. A large number (unsurprisingly) chose not to stay.

I believe that similar programs will evolve in the future; however, I still agree with what the other poster said about charging $5 for parking.