Is there a doctor in the house? Or, why are my elderly relatives told to go the the EMERGENCY room?

My mother is in the hospital right now.

She has had tingling in her limbs for over
2 years and been dealing with these problems
with her doctor.

Yesterday, her doctor told her to "have herself
admitted through the ER" today is she didn't feel
any better.

This happens with my aunt's doctor, too.

HOURS in the ER.

Do they NOT WANT TO DO THE PAPERWORK?

Is it some kind of scam?

Who benefits?

I KNOW that emergency rooms are SORELY overtaxed
EVERY day of the year. ...

so WHY do doctors not admit people through "normal" channels
anymore?

Mine doesn't. :-(

If he just says, "go to the ER."

I'm not sure when this concept of sliding everybody over to the ER started, but it really clogs the system, plus makes people wait who really don't have the capacity to do so.

answering machines. Very rarely does someone pick up the phone and leaving a message means somewhere, at some point, may call you back at some time...

primary care doctors and thus are forced to go to the emergency room for non-emergency care.

:shrug:

I think we'll see a lot more of this. :(

My aunt is also fully covered.

so are the insurance companies.

When the feds cut back, the states have to both fill in AND cut back, too, because they aren't getting the funds. This is going to be a terrible mess for a lot of people.

Most insurers require pre-approval for admission and they want results of tests, etc. that are obtained in the ER. There is very little direct admitting anymore, expect for things like deliveries and scheduled surgeries.

Hospitals and doctors are taking a CYA approach because the insurers will use any excuse not to pay.

Sad, but true.

about indigents clogging up the ER's.

When it's apparent that a HUGE part of the
problem is the admittance policies.

from the other parties.

I don't think there is any way to fix it without a single payer. You got a lot of great answer here, and the diversity of those answers are an indication of what a mess this is.

sorry about your family members. I hope they are doing well.

:hi:

She is OK, it really just dawned on me today
that this was the NORM!

:crazy:

My mom is having trouble walking, I'm sure
that they will shoot her full of cortisone
and discharge her in a few hours...

could be that they don't have office hours today--

Could be the MDs don't have hospital privileges--not all MDs do.

....dump those patients on to the hospitals because the US government has been dragging their feet on paying doctors.

My 82 year old father in law was getting diabetic supplies through Liberty Medical and they sent him a letter a month ago explaining they wouldnt be able to fill his prescriptions until after the first of the new year due to Medicare billing problems.

The doctor just doesn't want the hassle of it. If you go to the emergency room in the hospital where the doctor is an attending physician, they'll do all the work, and he can just show up for a few minutes after the admission, if any.

At the hospital, they'll run all the diagnostic tests, based on the resident's call, get your relative admitted, then let the doc know about it, and he can show up during his normal hospital visiting schedule.

Of course, the problem is that there are all these bills to deal with. Insurance will cover it, especially with Medicare and a supplement, so nobody really deals with the money issue. It's a waste, of course, and the doctor could have seen your relative in his office for this chronic thing, run just the tests needed, after consulting his records, and everyone would have saved a pile of money.

But, no...that's just too darned much trouble, and doc couldn't bill all those hospital visits, which go for more than an office visit.

told by her doctor to go to the emergency room to be admitted to the hospital for a medical problem that he had been treating her for. She waited in the ER treatment room for over 12 hours before being taken to her room.

A physician has to see the person being admitted to evaluate and write orders to make sure there are no unsuspected problems. For instance, people will say "This is the same thing I have had all along" and yet it will turn out that there is something new that really brought them to the ER like the flu or a kidney infection or a heart attack or a head injury with a subdural or diabetes out of control. You can not just stick people on the wards on their say so. Maybe they need to be in the ICU. The staff physician is right there to check them out. When I was in practice, I noticed that my African-American patients were much more likely than patients from other ethnic groups to be worried about seeing a doctor they did not know for their admission orders, but this is standard procedure. After the admission, either the regular doctor or a hospitalist will take over. The advantage of a hospitalist is he or she is in the hospital all day to get tests done, procedures etc. That leaves the clinic doctor in the clinic all day. An ideal practice for someone who is in and out of the hospital a lot will have its own hospitalist so you get to know that doc plus your clinic doc.

I know that when I had my second child, I was
admitted without an ER visit.

My aunt ALWAYS goes through the ER, regardless
of the complaint.

any other way. Probably isn't, at the two hospitals I went to.

I went to the ER with my 1st kid...she was NOT
a scheduled C-section.

patients frequently assume their personal physician can be there 24/7 to take care of their needs. As you know, it's not realistic or even possible, but it as the nurse caring for them, it happens all the time as evident in this thread.

Sending patients to the emergency room drums up revenue where it's needed.

I worked in the business office at a small community hospital right after high school graduation & I overheard a very key conversation between two doctors that I wasn't supposed to hear in regard to drumming up business for the hospital. I worked the night shift during which only one office worker was assigned to work.

After a board meeting one night, a couple of doctors -- one with seniority who had been with the hospital since its inception & one intern with seniority -- walked into the corridor right outside the office glass window, talking in hushed, but griping tones. From what I heard, the doctors were told at the meeting to admit as many patients as possible, for what I understood to be for whatever diagnosis the insurance companies would accept.

Both doctors were appalled at the idea. As weeks went on, I made it a habit to look at the register to see the number of patients admitted & who their doctors were. Just as the conversation I heard, the number of patients grew about one-third more than average. Consistently, nearly every one of the patients was admitted by the hospital's chief of staff who gave the order to admit as many as possible. The honest, maverick doctor whom I overheard had maybe one or two admitted, the norm for him.

It's a business. I'm wary of anything they do that defies common sense. I'm curious as to what answer your mom's doctor would give you when asked about the emergency room.

And good luck to your mom. I wonder if it's a circulation problem?

We really don't know WHAT it is...but my father
passed away from ALS, so almost any other diagnosis
is acceptable.

She is 74, and I notice that problems with nervous
systems and muscle atrophy seem to creep up in
people over 70.

She usually deals with it very well, but she is
afraid of the "tingling".

in the last three decades.

You'd get better care in the Third World for most ailments.

It saves them from "getting in trouble" with the insurance companies for ordering too many tests and puts the burden on the hospital.
It pisses me off to no end--and when my old doc told me to go the ER, I told him no way. I would wait and make an appointment.
I DO NOT want the huge copay for the ER when he can order the same tests in the office.
I've also turned it around on him and told him to direct admit me if he felt I needed it--but the ER was a no-go.

If the hospital orders the tests, then the insurance must
pay for them...yes?

If your doctor orders tests that aren't covered by your
insurance, they you might get stuck paying for them...

...am I getting warm?

When I was pregnant with my second child, my OB sent
me for an amnio that was NOT COVERED by my insurance.
How was I supposed to know what procedures were covered
or not?

They tried to bill me $700.00 for it, but backed off
when I cried FOUL!!

It is either covered...or not and the insurance company will act accordingly. The only difference is who gets stuck with the bill in the end--the physician or the hospital or the patient.
Currently I am fighting with my insurance company over a surgery they authorized but now say they determined it was not medically necessary.
I just filed it with the State Board of Insurance. Luckily I have excessive documentation and correspondence. I'm not even going to deal with their ridiculous hoops they want me to jump through for their "grievance procedure".
They can pay it or get fined. Matters not one whit to me.

to my regular doctor. The ER docs made me feel human and that how I felt mattered. I would gladly go to the ER every time I need to see a doctor from now on!

When I go to see to my regular doc, I feel like I am getting fast food at McDonalds, I am in and out of there so fast. They never completely answer all my questions, nor do they "care" for me at all. I really feel worse when I leave there and so damn frustrated and annoyed that I will shortly be getting a $20 copay bill in the mail for next to nothing!

Our medical system in this country SUCKS BIG TIME! :grr:

Or did you go there because of acute pain?

My concerns are about doctors sending
patients through the ER when they are
not in acute pain/need.

I don't know why/how/if admittance
policies were always this way, or if
it has something to do with how insurances
view the test requests....

But that said, I hate going to the doctor, so I only go to the ER when I'm absolutely miserable or I'm not getting any better after a doc visit or two.

I don't think it's a matter of that...

I'm just wondering whatever happened to
"regular", scheduled hospital admittance
policies.

Guess they don't want their patients going
the "out-patient" route or something.

Seems funny when there is so much made of
over-crowded waiting rooms and ER mayhem.

That ended up involving emergency d&c and would have cost $12,000, everything was covered with the exception of the $100 co pay.
For doctor ordered tests and treatments, it is something like 80-90% coverage, whici is good but still can get expensive. Insurance companies may vary but I don't think that mine is the only one that has better coverage for the ER.

that would be my guess..

She was nagged into the emergency room by a friend. She's been suffering from dizziness and chest pain, and was going to call to make an appointment. Her friend insisted she be seen immediately, rather than waiting a week for an open slot, and drove her to the emergency room.

We're waiting for the outcome of the tests they ran.

Perhaps the ER was recommended because the appointment book is full, and it sounded like a situation that shouldn't wait?

I thought it odd that her doctor tells her
that if she is "not feeling right" by tomorrow,
to go "through the ER" for tests.

She had my sister-in-law drive her ACROSS TOWN
to the hospital he suggested.

that doctors don't seem to leave any unscheduled time in their day for patients who may have an urgent need. I guess, from a financial standpoint, they don't want to leave billable hours unfilled.

From a human standpoint, though, that leaves emergency rooms or "urgent care clinics" taking care of the majority of immediate needs.

Even my dentist does this; if I need to reschedule an appointment, there is a 6 month wait for the next free time.

In some cases, the long waiting periods for an appointment may be the natural results of HMOs limiting coverage to "approved" doctors. They don't "approve" enough of them.

I work in women's health and when it's a known ectopic pregnancy or miscarriage requiring a D&C for instance, it's not an issue. We get the labs, start the IV, and get everything going. When it IS an issue is when the diagnostics are uncertain. Hospital units are designed for patient care, not triage. ED can triage. Often inefficient, but not always. I had to take my 7 year to an ED while traveling for an asthma attack. We were seen with minutes.

The doctor is probably enjoying their sunday afternoon with their family.

even during doctor hours. They just say, take her there.

Or have things changed in the last couple of years.

I don't remember doctors telling people to go into
emergency like they do today.

Every countless times my father, mother, niece, and other family members were admitted since then was through emergency. Even when you call the doctor, the receptionist just says "go to the hospital."

Oh and before snark....It was for a Meckeles Diverticulum. Not insanity.