I just wanted to mention one of our patient advocates, Larry Hall, who already has seen more than his share of trouble now had to deal with the Duke University emergency room, a 12 hour wait, and 6 hours of driving back and forth. We’ve decided to make this public and are waiting on a response from Duke.
That’s not unusual unfortunately. I had a similar situation here in Seattle. It was a Friday afternoon and my chest catheter clotted needing replacement. Because my regular vascular surgeon wasn’t available until Monday, I was told to drive to Seattle (2 hours in rush-hour traffic) to emergency to have it replaced. 6 hours later - and no surgeon available - I was told to go home and make an appt the next day with a surgeon who keeps Saturday hours. I was charged over $500 for that ‘event’. When I complained they waived my co-pay portion of the bill but my insurance company still had to pay.
Unfortunately, ER’s work on a triage basis–the sickest people are seen first. At any given moment, even if it is almost your “turn”, six traumas could show up and throw everything into disarray. ER’s are about the worst place to go for medical care if you’re in a hurry, unless you have something obviously majorly wrong (and preferably bleeding)–like a steel pole sticking out of your head.
Some ER’s in L.A. have started advertising their wait times on billboards along the highway, which is not a bad idea. But I’m not sure there’s really much that can be done, when the whole point of an ER is to see emergencies first.
A good explanation by the American College of Emergency Physicians of why patients have to wait in emergency departments can be found at:
http://www.acep.org/patients.aspx?id=25908
What if one gets really sick while waiting a long time in an emergency room and is about to vomit, have an uncontrolable bowel movement, is in pain or might pass out yet is told there are no cots available yet?
If I were the insurance company, the hospital would have been told to take a flying leap over the cliff. The way to get these individuals attention is to slam shut the insurance company checkbook. By the time, the hospital pays the attorney, LOL, it would not be worth it, unless they are on retainer. If they made a stink about it, I would tell them, “Enjoy your new found negative press in media.” Have a nice day. Now, you can understand why we think the medical profession is arrogant.
I can understand Duke having emergencies coming in, what I can’t understand is how they could send him home after 12 hours with no meds and no help.
They will usually give you an emesis basin if you feel nauseous, but vomiting is not necessarily an emergency, compared to bleeding (depends on the cause). In CA, there was a woman who was in the emergency room for more than 24 hours, and had spent some of that time unconscious on the floor–that was poor care. But any ER that can document the arrival of traumas is pretty much off the hook for other, lesser problems.
Good point. That would depend on who they had on call, and they should have had SOMEONE on call. I have heard of docs who refuse to answer their pages when they’re on call, which is completely irresponsible and a breach of their contract with the hospital.
The only other incident I had with an emergency room was the time I went to ER following one of the many surgeries on my bladder due to bladder cancer. Again it was a weekend. I ballooned up to look like I was 8 months pregnant. The day before I even went to my surgeon complaining of pain and even TOLD the doctor I was pretty sure I had a hole in my bladder and even pointed to the exact spot on my abdomen. He sent me for an ultrasound which showed nothing and sent me home with instructions to go to ER if it got worse. It did get worse. I could barely move. I was so distended that driving and getting in and out of the car was almost impossible. In ER, I waited for 4 hours in excrutiating pain before they saw me after I pleaded with them. I also told them what I thought the problem was. Instead they gave me an enema for constipation and sent me home telling me to come back the next day if it was worse. It was obviously. I told them I needed a CT scan which they didn’t want to do because of the cost. The CT tech wouldn’t even help me on or off the table. I though my insides were going to split open. I was in so much pain I was crying uncontollably. The scan showed a ruptured bladder with fluid all throughout my abdomen. 6 hours later in ER I begged them to place a catheter in my bladder - which finally began to relieve some of the excrutating pressure. The only treatment for the hole in my bladder was a 2-day stay in the hospital with a catheter to allow my bladder to drain and heal on it’s own. I will never know if the mets that developed 2 years later were due to this situation. I am still appauled at the incompetence I experienced at so many levels. The ER was a dangerous place to be.
Oh my gosh, Wendy, what a horror story! Unfortunately, pain is one of those things that ER staff can’t see. Even if you’re crying, they are skeptical, because there are a number of folks who ER shop claiming migraines and other hard-to-verify pain conditions and seeking narcotics. What’s clear to them is blood. Anything else is less clearcut for them. 
I have to wonder what ever happened to erroring on the side of caution - looks like they can mess up a lot of good people worrying about a few bad apples.
I did want to mention I have some good news and some bad news. Larry, one of our patient advocates, has had his surgery moved from the end of January to the beginning of the month - http://dialysisethics2.org/forum/index.php?topic=481.0.
The bad news is we are getting the run-around in obtaining a response. So Carl Ginsburg, a lawyer/journalist friend, has graciously offered to help. We like to settle these matters with less fanfare, but Duke seems to be insisting. So if they want to meet one of our heavy-hitters - so be it.
Larry made it through surgery, but I understand he is in the ICU:
We did get this update:
"Larry just called. He is fine and feeling better. I received a text message from a family member that he was going to ICU. It appears that he did better than expected and is now in his room. He did not have to go to ICU as previously thought.
Larry wishes to thank all of those who kept him close to their hearts."
We’ve decided to post pictures of Larry’s arm - you might understand why we have been upset:
http://dialysisethics2.org/forum/index.php?topic=481.30
The insurance company should refuse to pay for such nonsense.
Something we can both agree on!
I thought I ought to mention I talked to Larry and he is out of the hospital and it looks like he is coming along fine!
Visiting the ER can literally be a crap shoot. Sometimes there is no wait or a minimal wait and other times it’s hours or they turn you away like the incident above. Still as difficult as the ER experience can be, it’s good that it’s there to help us in times of trouble.
Sinclair
I guess they have to see quite the range of people too: everything from people coming in for the sniffles to people who waited until they could barely crawl in (the ones who really get expensive since they waited).