VA ER Closure

[Chonal Atresia]

For everyone considering working at the VA after active duty, you should read this article. This is what happens to your ER when you pay your physicians peanuts compared to what they can earn in the private sector. Somehow, the real reason for the closure never made it into the article. Until the government pays VA physicians commisurate to what they can make in civilian medicine, these problems will never end.

http://abc11.com/health/fayetteville-va-emergency-room-to-temporarily-shut-down/314090/

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[notdeadyet]

I'm not really seeing that this ties to VA salaries. Lots of VAs are moving in this direction. An ER is an expensive beast to run without the volume.

VA ERs have also gotten in trouble because the lack of facilities in the hospital backing it. An ER with no cath lab or other facilities can make thee placese sometimes not much better than glorified triages. For lots of VAs, this is a good move.

 

[Chonal Atresia]

I'm not really seeing that this ties to VA salaries. Lots of VAs are moving in this direction. An ER is an expensive beast to run without the volume.

VA ERs have also gotten in trouble because the lack of facilities in the hospital backing it. An ER with no cath lab or other facilities can make thee placese sometimes not much better than glorified triages. For lots of VAs, this is a good move.

You did not read the article thoroughly. The ER is not "moving in this direction," they had no choice at this point in time because they have no ER physicians. They are actively pursuing another contract in order to make their dysfunctional ER functional again.

 

[j4pac]

NH Pensacola just lost their ER. It was underutilized and they couldn't justify keeping it open. Instead they replaced it a urgent care clinic staffed by non-ER trained physicians.

The problem with the move to urgent care is that ambulances can't deliver to an urgent care clinic, so the hospital loses it's primary means of admission. As of now NH Pensacola has an inpatient until and one ICU bed (primarily as a holding spot for ICU transfers). They are going to lose their inpatient service without an ER. There is just no way that the admissions from clinic will be high enough to keep that boat afloat. They are losing their residency program as well.

It's a short sighted decision in my opinion. When big Navy sees all of their patients are going to the civilian sector for ER visits and even more so hospital admissions, they will reconsider. They will realize that though the ER may be a loss...that the benefits gained by having an inpatient unit is a net gain. It would also allow more residents to stay within the Navy Hospitals.

 

[fez68w]

I like the journalist's words at 1:45

 

[deuist]

It's a short sighted decision in my opinion. When big Navy sees all of their patients are going to the civilian sector for ER visits and even more so hospital admissions, they will reconsider. They will realize that though the ER may be a loss...that the benefits gained by having an inpatient unit is a net gain. It would also allow more residents to stay within the Navy Hospitals.

The article was about VA hospitals, not military facilities. That being said, the military should absolutely get out of the business of medicine – particularly in these cases when they cannot sustain an appropriate volume to keep an emergency department, inpatient unit, or even an entire hospital open. Many of the smaller active duty hospitals are struggling to reach 50% occupancy of the inpatient side, meaning that the units are hemorrhaging money. If these were civilian hospitals they would all go bankrupt and be closed unless they were in a high needs area.

 

[j4pac]

The article was about VA hospitals, not military facilities. That being said, the military should absolutely get out of the business of medicine – particularly in these cases when they cannot sustain an appropriate volume to keep an emergency department, inpatient unit, or even an entire hospital open. Many of the smaller active duty hospitals are struggling to reach 50% occupancy of the inpatient side, meaning that the units are hemorrhaging money. If these were civilian hospitals they would all go bankrupt and be closed unless they were in a high needs area.

But you have to consider the cost of sending a patient to the civilian sector vs military hospital. It's significantly higher...so in the grand scheme of things...it may still be worth it to keep the Navy hospitals open. Not to mention that I do believe that there is an intrinsic benefit of having a military hospital and anyone who has ever worked at a Branch clinic knows this. Administratively it is significantly harder dealing with civilian hospitals.

 

[Chonal Atresia]

Still no fix to this mess. Hard to believe some people would prefer to have the government control medical care for everyone.

http://www.fayettevillenc.va.gov/

 

[HighPriest]

Still no fix to this mess. Hard to believe some people would prefer to have the government control medical care for everyone.

http://www.fayettevillenc.va.gov/

Is that really hard to believe? Stupid, yes, but hard to believe? People just don't know what that means, and they've become used to spoon feeding as a means of survival.