Monday, March 30, 2009

Emergency Rooms- The Only Choice?

You find yourself debating the idea of purchasing groceries for your family, or seeing a doctor for a recurring cough that seems to be emitting parts of your lower lung. You'd borrow money from someone in your family, but everyone is on edge about losing their jobs, and you are not sure yours is going to be around much longer either. We're cutting coupons, waiting extra days between laundry so we can use less electricity because the cost of running our lights has gone up so much. Every where we turn we're being told how much worse it's going to get. Yet, we're coughing, and can't figure out what we should do about seeing a doctor.

Not too many years ago, former President Bush stated that those who were unable to afford health insurance or medical care from a primary physician should just go to the emergency rooms and then the hospitals could sort out the mess. In February of 2005, Reuters posted stories that more than 50% of the bankruptcies in the United States were filed due to medical expenses. In 2006, it was reported in several news sources that medical billing errors, and down right scams helped create an unmanageable number of cost overages. Certainly double and triple billing of patients has become common practice as medical billing services hand off account files to debt collection agencies even AS patients are in good standing with payments. We're being billed out of good health care.

Visiting an emergency room should be considered in the same way someone would consider dialing 9-1-1. If you can get to a doctor who has a regular rapport with you, knows your history, and can tell the difference between your "normal ranges" and the ranges another patient may have as normal then do so. An emergency room isn't the best answer. So many patients are using this system as the only form of health care- causing those who have true emergencies undue pain, long waits before seeing a professional, and in some cases, death.


If you have to hit the emergency room because it's after hours, or your doctor can't see you for several days, or you are no where near home and are very sick- then you can do something NOW to plan for THEN. Put a copy of your medical records on CD or on a Jump Drive. Add any tests, copy your food diaries, mark down any doctors' contact information you've got. And, if you have a living will, advance directives, or even a designated patient advocate- put that on the drive, too. Keep this with you on your key chain or on a necklace- and you WILL have better care in emergency situations. If you use a service such as GoogleHealth or MedAlert, copy those files too. ANYTHING that gives your emergency room doctor more information regarding your health is FAR better than just hoping he or she will understand from the symptoms at hand.

Jump drives are available for under $5 for enough space that can hold dozens of xray screenshots, medical files, legal files, and you can load them up via Mac, Windows, or even Linux. Save your files as TEXT or as RTF, (rich text format), or even better print them as PDF. You can get free PDF programs such as BullZipPDF from SourceForge.net. If you update your files EVERY time you come back from a doctors office, you can ensure that your current medications are listed.

Include NON-prescription medications, supplements and even if you're on a diet such as Nutrisystem. All of this affects your care in an emergency. And, ensure that the contact information for your next of kin, friends, and even someone from work is listed in case you need to have people come to the hospital and speak on your behalf. I have marked a jump drive with MEDICAL ALERT, in a permanent marker. The drive has a loop which I've attached to the Keychain Loop of my wallet. When someone checks for my ID or Insurance, the drive is available, as well. I do NOT include my social security, mother's maiden name, or specific information that would cause identity theft or worse. But, my health information is stored- and that could save my life.

The Emergency Room system isn't reliable. A person who comes in on an ambulance with a sprained ankle may end up seeing a doctor before the woman who came into the waiting room complaining of chest pains. A man bleeding may be seen before a child with a high fever. You can never tell from one day to the next nor one hospital to the next what the priorities of being seen will be. Then, once you see a doctor you may end up with a new resident, or you may end up with the head of surgery. The wait may be just a few minutes, or a few hours. One doctor may think you need to be admitted, another thinks you just need antibiotics. Having files with you can help you.

There are other options. In the last ten years, "Urgent Care" centers have become part of our neighborhoods. You can see doctors there after hours, and get to see the same doctors, so they are familiar with your history. Local pharmacies are offering "Quick Clinics" so you can see a dcotr if you are coming down with a flu or cold, but can't see your regular doctor for several days. Medical Schools open up outreach clinics, and there are even clinics that drive to you. Some of these services cost far less than standard emergency room fees, and still others are free.

If you have a community center, local hospital, school district, or even a public housing office near by, look in your weekly calendar section of your paper, Craigslist, or even the newsletters. There are free health services offered for neighbors, seniors, the disabled, caretakers, single parents, children. Dental schools offer discounts. The United Way lists free counseling centers, discount health care centers, and even local health spas and gyms have screening days. If you are sick, can't afford a regular doctor, but need care- check your local calendar for FREE or reduced cost options. I worked at a company about 20 years ago that even gave us free Diabetes, weight management, and heart exams because it wanted to retain a healthier, happier employee. Those days may be long gone, or you may be missing out on an employee benefit you may not even be aware exists.

Today's questions- When cutting costs, do you use Online health services or do you prefer to see an emergency room doctor? Is someone in your family aware of where you keep health information, or legal papers, in case you are unable to answer doctors questions? Where do you go to when you need to see a doctor after hours, or when you can't get an appointment?

3 comments:

  1. i am not sure if you are aware of this but unfortunately most hospitals cant access the USB ports on their computers (b/c of HIPPA regulations regarding transferring data most hospitals block access to their USB ports as a precaution to avoid potential HIPPA violations.)...I learned this the hard way...also, a usb device or cd is of little help in an ambulance as well. You may want to consider www.WELLalarm.com. They have an Emergency Service plan that comes with a sticker for your cell phone for 29.99 or a card for your wallet and a tag for your keychain amoung other products. In an emergency, responders or the hospital just call their 800 or go their mobile website (found on all their products) and access all of your vital info including a complete list of medications and dosages, allergies (and if relevant, where your epi-pen is kept), medical conditions, blood type, vaccinations, doctors information and emergency contacts and more. They can even have the info texted to them! at the same time it sends a text to your emergency contact letting them know their is a problem. You can import your info from google health i think as well. they have a number of other cool features too including medication and doctor appointment reminders, storage of key legal docs ability to fax info from you iphone etc. i HIGHLY recommend it. it has been a huger lifesaver for me.

    ReplyDelete
  2. i am not sure if you are aware of this but unfortunately most hospitals cant access the USB ports on their computers (apparently most hospitals block access to their USB ports as a precaution to avoid potential HIPPA violations)...I learned this the hard way...also, a usb device or cd is of little help in an ambulance as well. You may want to consider www.wellalarm.com. They have an Emergency Service plan that comes with a sticker for your cell phone for 29.99 or a card for your wallet and a tag for your keychain amoung other products. In an emergency, responders or the hospital just call their 800 or go their mobile website (found on all their products) and access all of your vital info including a complete list of medications and dosages, allergies (and if relevant, where your epi-pen is kept), medical conditions, blood type, vaccinations, doctors information and emergency contacts and more. They can even have the info texted to them! at the same time it sends a text to your emergency contact letting them know their is a problem. You can import your info from google health i think as well. they have a number of other cool features too including medication and doctor appointment reminders, storage of key legal docs ability to fax info from you iphone etc. i HIGHLY recommend it. it has been a huger lifesaver for me.

    ReplyDelete
  3. The studies I'm looking at seem to be showing that there are definite advantages to having the profiles on disk, too. (AMA, Jama, lancet, and there's a note in the FDA consumer site). BUT I see the advantage of such a service in an earlier blog- I posted about Google Health, and several other online sources that don't charge- but don't offer the same service you're mentioning here. Thanks so much for posting this.

    Also, many sources are recommending that families keep fingerprints, hair samples, and even a sample of DNA in a box in the freezer, and if possible either a wax model for teeth, or a copy of dental xrays in an accessible location. It's also a matter of "what if" in case of accidents that leave our bodies unrecognizable, missing family members, or other tragic moments.

    ReplyDelete

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