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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [dry heat] [ In reply to ]
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dry heat wrote:
Urgent Care.
Urgent Care isn't going to touch most lacerations. They just send you to the ER

Also, DIY isn't going to prescribe you antibiotics to ward off infection, or give you a Tetanus booster if it's been more than 5 years since your last one.

As an ER murse, I'll usually try and bandage/glue most lacerations, but beyond a certain in-my-judgment line, I'll take it to the ER.

They're expensive because they're open 24-7 and (generally) know what they're doing, and worth it.

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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [bcart1991] [ In reply to ]
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bcart1991 wrote:
dry heat wrote:
Urgent Care.

Urgent Care isn't going to touch most lacerations. They just send you to the ER

Also, DIY isn't going to prescribe you antibiotics to ward off infection, or give you a Tetanus booster if it's been more than 5 years since your last one.

As an ER murse, I'll usually try and bandage/glue most lacerations, but beyond a certain in-my-judgment line, I'll take it to the ER.

They're expensive because they're open 24-7 and (generally) know what they're doing, and worth it.


I totally agree ERs have value and back in the day when you knew you could get it done for $1k it totally made sense to go there. But 15% of insured patients walk out of ER (more likely get in the mail a year later) a big surprise bill these days. It’s pretty much financial Russian Roulette to go to the ER even with good insurance.

https://www.google.com/...rprise-bill-63827975

I’m curious how you think the system evolved to where we are today where even with insurance you have to hold your breath for a year to see if at some point an out of network radiologist or lab or other was not called into your care resulting in a massive financial issue on top of you insurance which is probably a $20k/ year cost?
Last edited by: Moonrocket: Jun 23, 19 11:23
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [Moonrocket] [ In reply to ]
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Moonrocket wrote:
I’m curious how you think the system evolved to where we are today where even with insurance you have to hold your breath for a year to see if at some point an out of network radiologist or lab or other was not called into your care resulting in a massive financial issue on top of you insurance which is probably a $20k/ year cost?

The bills are that way because we see 100 patients a day who walk in knowing they're not going to pay a cent of whatever charges they run up. Someone has to pick up that tab, that someone is us.

Nothing is going to change (in Primary Care, mostly) until the consumer is put back into the cost-per-service equation. Insurance/Medicare/Medicaid have taken the consumer completely out of the transaction, so what incentive is there to have any sort of cost analysis or competition?

Insurance should be insurance across the board. No more networks or provider groups.

People also don't realize that medical technology is damned expensive. Can't run down to Wal Mart and get a head CT or EKG. Yet...

ER will never be profitable because it has to be open 24/7/365. Nor do we care about your 2 week old thumb injury, when the guy 2 rooms down can't breathe. But guess who gets the Customer Satisfaction Survey? Guess which one can directly affect my pay?




There's a locally famous case here of a person who got a severe infection and lost a few limbs after visiting our ER, and tried to sue the hospital and doctors who treated her. Person has been on local TV, touted as a "hero" and "super strong," etc. Hospital settled out of court because the person's case would have gotten destroyed in court. Here's a tip - don't go swimming in a lake two days after getting a dozen stitches. The resulting infection will not be the doctor's fault.

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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [bcart1991] [ In reply to ]
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bcart1991 wrote:
Moonrocket wrote:
I’m curious how you think the system evolved to where we are today where even with insurance you have to hold your breath for a year to see if at some point an out of network radiologist or lab or other was not called into your care resulting in a massive financial issue on top of you insurance which is probably a $20k/ year cost?


The bills are that way because we see 100 patients a day who walk in knowing they're not going to pay a cent of whatever charges they run up. Someone has to pick up that tab, that someone is us.

Nothing is going to change (in Primary Care, mostly) until the consumer is put back into the cost-per-service equation. Insurance/Medicare/Medicaid have taken the consumer completely out of the transaction, so what incentive is there to have any sort of cost analysis or competition?

Insurance should be insurance across the board. No more networks or provider groups.

People also don't realize that medical technology is damned expensive. Can't run down to Wal Mart and get a head CT or EKG. Yet...

ER will never be profitable because it has to be open 24/7/365. Nor do we care about your 2 week old thumb injury, when the guy 2 rooms down can't breathe. But guess who gets the Customer Satisfaction Survey? Guess which one can directly affect my pay?




There's a locally famous case here of a person who got a severe infection and lost a few limbs after visiting our ER, and tried to sue the hospital and doctors who treated her. Person has been on local TV, touted as a "hero" and "super strong," etc. Hospital settled out of court because the person's case would have gotten destroyed in court. Here's a tip - don't go swimming in a lake two days after getting a dozen stitches. The resulting infection will not be the doctor's fault.



Ding ding ding!!! This is great and I could not have said it any better.
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [eye3md] [ In reply to ]
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eye3md wrote:
Ding ding ding!!! This is great and I could not have said it any better.

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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [slink] [ In reply to ]
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slink wrote:
Even in Canada where we don’t pay out of pocket per visit I would still avoid going in for stitches if possible.

My brother in law is a vet and regularly stitches himself, his kids and the neighbourhood kids so they can avoid 8+ hours of the waiting room.

Why kind of fucked up neighborhood do they live in that constantly requires the entire fucking family and all the neighbors to receive regular stitches???

Pretty sure I would move.

Even windywave's shit-hole Chicago battlefield neighborhood sounds safer.

If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [bcart1991] [ In reply to ]
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bcart1991 wrote:
eye3md wrote:
Ding ding ding!!! This is great and I could not have said it any better.

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Vote early, vote often!!!

You live in Chicago too?
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [JSA] [ In reply to ]
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JSA wrote:
slink wrote:
Even in Canada where we don’t pay out of pocket per visit I would still avoid going in for stitches if possible.

My brother in law is a vet and regularly stitches himself, his kids and the neighbourhood kids so they can avoid 8+ hours of the waiting room.

Why kind of fucked up neighborhood do they live in that constantly requires the entire fucking family and all the neighbors to receive regular stitches???

Pretty sure I would move.

Even windywave's shit-hole Chicago battlefield neighborhood sounds safer.

To be fair they usually don't stitch you up when DOA
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [windywave] [ In reply to ]
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windywave is on point today

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Last edited by: bcart1991: Jun 23, 19 17:08
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [bcart1991] [ In reply to ]
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bcart1991 wrote:
windywave is on point today

I usually am
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [windywave] [ In reply to ]
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windywave wrote:
To be fair they usually don't stitch you up when DOA

Seems like in those cases the stitching would be done at the funeral home, not the ER.

Admittedly I have no direct experience with this.
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [eb] [ In reply to ]
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eb wrote:
windywave wrote:
To be fair they usually don't stitch you up when DOA

Seems like in those cases the stitching would be done at the funeral home, not the ER.

Admittedly I have no direct experience 9with this.

That's included in the full monty burial package.
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [windywave] [ In reply to ]
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windywave wrote:
eb wrote:
windywave wrote:
To be fair they usually don't stitch you up when DOA

Seems like in those cases the stitching would be done at the funeral home, not the ER.

Admittedly I have no direct experience 9with this.

That's included in the full monty burial package.

I wonder if I can hold my breath for a long time if they are cheaper or more expensive than the ER?
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Re: What ER cost on a high deductible would make you decide to stitch your own 6” gash [Moonrocket] [ In reply to ]
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Moonrocket wrote:
windywave wrote:
eb wrote:
windywave wrote:
To be fair they usually don't stitch you up when DOA

Seems like in those cases the stitching would be done at the funeral home, not the ER.

Admittedly I have no direct experience 9with this.

That's included in the full monty burial package.

I wonder if I can hold my breath for a long time if they are cheaper or more expensive than the ER?

You have to sign a waiver since normally there's no medmal for morticians.
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