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So upset right now :( [vent]

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    So upset right now :( [vent]

    I've been having a problem since the weekend with severe abdominal pain. I waited for it to get better or worse, and when it got worse it was 11 PM, and I went to the ER. I've been to the ER three times in my life: when I was born, for surgery, and when I was diagnosed. I was discharged at 3:30 AM. They did a workup and the dr. decided that it was an ileus causing slow transit. I wasn't sure if I had wasted everyone's time or not, but told myself to focus on the fact that for once, everything was ok. I don't consider myself malingering, a frequent flier, etc.

    Four hours later, I got a letter from my GP telling me that I did, in fact, waste everyone's time [below]. I wrote back a letter saying I didn't appreciate the targeted beratement and that MS can cause complications, and that it probably wasn't best practice to discourage people from seeking emergency medical care. I got back a response that I was "taking it the wrong way." I don't even get it, are they going to get a reimbursement from my insurance company from retroactively managing what sort of care people seek with these kinds of letters? It would seem to me that would be offset by the liability they open themselves up to. Can you imagine getting third degree burns but putting off medical care because of this stupid letter?


    "Abdominal pain and cramping is not a medical emergency needing an ER visit.
    We believe the best care is often that provided by your own primary care provider who knows you
    best, can follow up on tests, and can help coordinate any necessary follow up care.
    [posted times of walk in] 8<

    a. Upper respiratory infections, flu and colds.
    b. Sinusitis, bronchitis, ear infections, headaches, and pink eye.
    c. Urinary tract infections, diarrhea, and vomiting.
    d. Injuries such as sprains and strains.
    e. Skin conditions, such as rashes, burns and infections.
    f. Camp forms, simple driver physicals, and simple job forms.
    g. Urgently needed prescription refills under certain conditions
    We encourage our patients to call the office for all urgent health problems or concerns, 24 hours a
    day, 7 days a week. We can help you decide on the best way to manage your care, sometimes
    helping avoid costly emergency room copays and delays. For an immediate life-threatening
    emergency call 911". . .suggestion to use ER that I went to.

    #2
    I'm big on not wasting anyone's time or frivolous use of the ED but would vehemently disagree that abdominal pain/cramping to the extent that you feel you need to go to the ED is an inappropriate use of emergency services. What if it had been diverticulitis? or appendicitis?

    I would be offended also but I guess the overall take home is that you now know they have a 24/7 hotline you can call for guidance should you have a problem after hours in the future. It is a nice service although their delivery in the form of that letter was poor. All they had to do was get rid of the first sentence and it would be welcome information. Don't take it personally and hopefully your feedback will encourage them to look at the tone of their message.

    Glad you feel better and that it wasn't more serious!
    He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
    Anonymous

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      #3
      Is your primary part of a hospital network? Wondering if so, if it is an internal rating of patients who use ER when "not an emergency". It is really odd letter, but do agree that nice you have 24x7 call access. Hope you are feeling better.
      Kathy
      DX 01/06, currently on Tysabri

      Comment


        #4
        That is horrible that they wrote you a letter like that. It’s good to communicate to patients that they have a hotline to screen from unnecessary visits. But the rest of what they told you infuriates me.

        I have been to ER probably 100 times since my dx. It’s the only way to get comprehensive medical care. Driving around for piecemeal tests and treatment gets impossible. Doctors offices give you 3 minutes and you can only have one thing wrong with you per visit.

        This week I have been lying in bed with a fever of 102, I got a huge blister on my right arm and most of the skin is torn off and probably a UTI. All night I’ve been debating whether to call an ambulance. Have an appointment next week with my PCP but that’s not until Wednesday. If I call an ambulance they will probably admit me and I can get everything cared for. One stop shopping.

        I think I will call them. If they don’t like it, and say bad things behind my back, *****. So much of what we are dealing with is not visible.

        Comment


          #5
          I am so sorry this happened to you. Stomach pain is a serious thing and should always be a concern to the ED. I went through this in 2008 and was immediately sent to surgery to correct a blockage. I ended up in the hospital for 12 days. This could have turned out badly if I had not gone in to be diagnosed.

          I hope you have an alternative hospital to turn to in the future.

          Wow. Unbelievable! Shame on them.
          Marti




          The only cure for insomnia is to get more sleep.

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            #6
            Abdominal pain from MS might not be an emergency, but what if you were having appendicitis (I know of 3 people who've had their appendix burst , just this year and then it really was an emergency and they spend weeks in the hospital getting IV antibiotics.) Or it could have been a bowel blockage...slow motility could lead to that and it is anvMS thing, but how is a dr. visit going to determine those things. I suppose they could send you for x-rays, but in our town, visits to an independent radiology office need to be scheduled, and other than that, you have to go to the ER to get x-rays, ultrasound, etc.

            I've discovered that if your doctor has sanctioned the trip to the ER either from a visit in his office
            or on the phone, triage goes much faster. But that wouldn't have helped in this case because he wouldn't have sent you anyway...sometimes you have to listen to your gut, literally and functionally.

            My doctor is very thorough and I have been in my doctor's office and been told to go
            to the ER right away and the doctor calls ahead and admits me if he thinks something's up, that avoids the emergency room altogether. Once they called for an ambulance to come and get me from their office. That was strange, making quite the spectacle of myself being wheeled out on the gurney through the waiting room of the doctor's office. Several times when I've been there and was very ill feeling, and my vitals are all wonky, he leans down, looks me in the face and says, "Do you think you need to be in the hospital." He knows I hate hospitals, but he also knows my weird MS autonomic attacks can cause all sorts of issues, so he'll go on my recommendations.

            I don't care what the doctor said to you, if you thought you needed to be in the ER, then that's where you should be, unless he had a better alternative. I think I might be doctor shopping if I got that sort of letter.

            And as to insurance, I read an article years ago about a certain kind of plan (one of the managed plans) where the doctor was encouraged by some incentive...not sure that was $$$ or other perk) for keeping their patients from going to the hospital.

            Sorry for your bad experience. I dislike doctors that dismiss rather than validate their patient's complaints.

            Hang in there.

            Comment


              #7
              Originally posted by rdmc View Post
              I've discovered that if your doctor has sanctioned the trip to the ER either from a visit in his office
              or on the phone, triage goes much faster. But that wouldn't have helped in this case because he wouldn't have sent you anyway...sometimes you have to listen to your gut, literally and functionally.
              Although I'm not defending that poorly written letter we don't know if OP would have been sent to ED had they called the 24/7 hotline for recommendations.

              I'm not sure how it works for ED visits but know that hospitals get dinged for repeat admissions within 30 days for the same condition. Much of this, imvho, is due to the ridiculous regulations, again jmo, that are not about quality care but are set up that way so certain payers don't have to pay for services rendered.
              He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
              Anonymous

              Comment


                #8
                Just because you have MS doesn’t mean you can’t have anything else. Lord spare us. You’d think a doctor might know that.
                In my town, the “Medical Centre” more or less owns the local hospital. Doctors from the other practices are not allowed to see you if you wind up there.
                Best wishes and Happy, um,New Year.

                Comment


                  #9
                  WHAT?????????????!!!!!!!!!!!!!!!!!!!!!! When you see some of the people in emerg and what they come in for (minor stuff) your story makes me shake my head. I'm so sorry you had to go through this.
                  Jen
                  RRMS 2005, Copaxone since 2007
                  "I hope to be the person my dog thinks I am."

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