| Over the last five years I've spent much more time in | | | | Sheer luck also played a prominent role. This patient's |
| the ER than I ever expected, mostly caring for loved | | | | condition seemed the most serious of all that were |
| ones, though a nasty kidney stone sent me there once. | | | | waiting to be seen, so priority was assigned to it. |
| While no expert, I do consult and write extensively in | | | | Quite providentially, a volunteer spoke the native |
| the fields of customer care and client relations, so I | | | | language of the patient and shared a cultural |
| tend to be attuned to obvious wins and losses in | | | | background, enabling her to literally translate an entire, |
| patient treatment. | | | | pertinent medical history in a few minutes, to the |
| Last night was one of the better experiences, if there | | | | attending physician. This calmed the patient and |
| is such a thing under emergency conditions. | | | | provided an early sense that she would be fully |
| All told, the stint lasted five hours. During that time, the | | | | understood, and her recitation respected. |
| patient received a CAT scan, an EKG and Echo EKG, | | | | Contrast this with what happened at the primary care |
| various blood tests, a chest x-ray, and all of the vitals | | | | physician's office the day before. |
| were monitored. | | | | The same patient waited five hours to be seen, |
| These tests were absolutely necessary to rule out | | | | before being sent to another location for an |
| ultra-serious heart and lung conditions. | | | | ultrasound--five long and scary hours, mostly alone in a |
| At long last, they were all negative, and the patient's | | | | room, suffering from shortness of breath and chest |
| treatment plan was clear and straightforward. | | | | pains. |
| While there were some long pauses between exams, | | | | The physician's business identity contains the |
| the medical team seemed like it was on its toes, and it | | | | reference: URGENT CARE. It was neither. |
| was the closest thing I have ever seen to a TV show, | | | | ER's are often the same way, if you don't have a |
| where everyone knows her role and does it, sweetly, | | | | referring doctor. On one occasion, I brought someone |
| competently, and without complaint. | | | | in that waited for three hours, wasn't seen, and left in |
| Why, on this night was the ER medicine so good, so | | | | disgust as the sun came up, resolving to see a primary |
| responsive and so thorough? | | | | care physician instead, later that day. |
| Several factors. First and foremost, the patient's | | | | That ER had the audacity to bill the patient, anyway, |
| primary physician, known to the hospital's staff, called | | | | for so-called "triage services," though no one else was |
| over to the ER before the patient arrived. Having done | | | | in the waiting room during the vigil. |
| a recent exam, he was fresh on the case and took | | | | Unfortunately, the bad episodes outnumber the good |
| this episode as an opportunity to secure tests he had | | | | by a factor of five-to-one. |
| already contemplated for later in the week. | | | | I have a suggestion for enhancing the health care |
| His call definitely altered the cueing and triage intake, | | | | reform debate. Focus on improving the emergency |
| making it ultra-efficient relative to my other | | | | room experience first, because comparatively, |
| experiences. | | | | everything else can wait. |