Saturday, September 26, 2015

Where Do You Go When You’re Sick?

There are some things you can’t legislate – like where do you go when you’re sick.

In the first place, you don’t know how sick you really are or whether you need medical treatment.

Second, chances are, you can’t get in touch with a doctor. This may be because you don’t have a doctor. It may be because you got sick in off-hours, and your doctor’s office is closed. If may be when you call your doctor’s office, you get an answering machine, which tells you the office is closed and to go to the emergency room, if you’re really sick.

Third, you may not know the alternatives, such a retail clinic, likely closed in off-hours or holidays. Or an urgent care center, the existence of which you are probably not even aware.

Four, if you call 911, they are likely to direct you to the nearest ER.

So what do you do? You go to the ER. You know it’s always open. You know doctors are there. You may even know ERs are legally obligated to see you regardless if you’re able to pay.

Paul Auerbach, MD, professor of emergency medicine, and an ER physician for 35 years, discusses your dilemma in today’s WSJ. “Why ER Visits For Non-Emergencies Aren’t Going Away.”

He makes 4 important points:

1) “You can’t teach patients economic lesions when they don’t feel well.”

2) “ It would be wonderful if patients could self-diagnose and always seek the appropriate level of care, but they can’t. It would be amazing if there were a system that promptly supported patients after work, and on nights, weekends and holidays, but there isn’t. There are so many patients for whom I need to do what I can, or they’ll fall through the cracks. They need a doctor, a social worker and a case manager. The nation would benefit if there were round-the-clock high-quality telemedicine specialists.”

3) “So let’s provide the resources to make emergency departments more efficient. Most of the time, the emergency department is a good entry point for health care, as long as the patient is then connected with other support. Emergency physicians know how to sort patients and offer treatment in an cost-effective manner, with the decency and compassion patients deserve.”

4) “ The most urgent needs are to build primary-care and specialist capacity that will effectively and appropriately assist patients who otherwise must rely on the emergency department, develop telephone and video-assisted care, promote wellness, harness the power of digital health, and finally, educate and convince patients that the system will serve them. Until these problems are addressed, the emergency room will continue to be the main event, not a safety net.”

Emergency or non-emergency? It is not for the person who is sick to decide. Only an experienced health professional can distinguish between the two.

1 comment:

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