Day before the full moon, so despite the beautiful warm weather, everybody in town who had nothing better to do decided to go to the ER because of whatever health complaints they’d had for the last month or three. Jeez - I think that if I walked into an ER waiting room and saw that it was so crowded that there was nowhere left to sit, I’d just turn around, walk out, and try some home care. (You know, take a few Tylenol, or take a laxative, or tape the hurt finger to the one next to it, or sterilize the wound with vodka and stitch it with dental floss, or whatever seemed to be appropriate to the situation.)
But nope - everybody was in it for the long haul. Worked nearly as fast as I could practically all day. I’m okay with that when I’m doing major trauma cases or tending to seriously sick people. But that’s not what today was about. I have never done so many x-rays and CT scans on so many basically healthy people before. Giving them the ol’ “radiation cure,” in other words. So if our descendents in a few millenia are really funny looking (like nostrils on top of their heads, or eyes on stalks, or that sort of thing), they can blame it on me.
Scrambling the human genome, one patient at a time.
Although I’m not in the healthcare field (besides the occasional band-aid on my children’s arms, legs, fingers, etc.) I can totally empathize with you. There isn’t anything worse than walking into an ER, with a real emergency and see all the nasty, loser-ish types that you KNOW are just freaks with nothing better to do than obsess over stupid crap.
Quite honestly, people are just frigg’n stupid. I don’t get the types that have a cold…a COLD…and yet insist on taking antibiotics. It’s absolutely obnoxious. Or those that use the ER as their GP. For my house, the ER is for, get this, EMERGENCIES. The “my kid’s chest is caving in as she breaths in the middle of the night”, or the, “my husband popped my 3 yr old daughters arm out of socket picking her up wrong” and after putting her to bed (as she said she was in pain) knowing we would have a GP office visit in the morning, she woke up 2 hours later hysterically in pain; so off to the ER we went.
For what it’s worth, I aplogize for all the idiots out there. If I could, I would banish every stupid person to the idiot island.
Years ago, before I was working in health care, I brought my then-girlfriend to the ED with a hot appendix. (As in, surgeon said after he took it out that he probably got it just before it ruptured.) There was a woman in the waiting room with a hurt finger who complained very loudly that my girlfriend was taken in first - after all, she (woman with hurty finger) had been there longer.
And as for taking x-rays of every damn thing - also before I did this for a living, I bruised my ribs working on a boat. Went to a doc-in-a-box clinic (workman’s comp issue), and he wanted to send me in for films. I asked whether he’d do anything different if they were broken rather than bruised. He said no, so I declined. Even then, I didn’t see the point. Still don’t.
been there done that my friend…you need to rent “Idiocracy” and fast forward to the hospital parts…i agree that health care in the US is f’ed up. Good luck.
Chance to find the dreaded incidentaloma? Looked up from a break in studying for surgery to read this… LOL.
Hadn’t heard that term before. I think I’ll start using it.
Another thing to mention about the demographic that comes to the ER just because they’re bored: it may not surprise anybody to hear that many of them are overweight or obese. This requires us to use much more “technique” (i.e. amount of radiation) to image than would be the case for smaller patients.
Many of the exams we do use a phototimed exposure, similar to what cameras use. In many of these cases, you hold down the “expose” button for a pretty long time, and the reading you get when you’re done (how many milliamp seconds) will just make your jaw drop. Better yet, sometimes the machine goes until you hit “backup time” (preprogrammed maximum exposure), and it panics. Sometimes you have to shut down and restart it. In a case like this, you half expect to see the patient steaming slightly when you’re done, or maybe smell slightly burnt. (Okay, that’s an exaggeration - but maybe not by much.)
And all for what? Lumbar spine films give a “normal” sized patient a radiation dose equivalent to about one year’s worth of natural background radiation, and much more than that on really large patients. It’s not uncommon for us to do them on obese persons in their reproductive years. For some mysterious reason, you see, obese people tend to have back pain. (Also knee and foot pain.) And in the case of this weekend, many of them decided to go to the ER for such chronic pain issues, just to “have it checked out.”
I have seen it from a patient side. My sons have severe haemophilia. When they get a bleed (usually muscular) we need to get them replacement factor 8 injected as soon as possible to prevent things from quickly deteriorating. Given the rarity of the condition there is only one hospital in Toronto that has a haemophilia clinic and we don’t live close to it - 55 km. As a result, we go to our local ER -2 km - to get the shot (it needs to be given intravenously). After a number of frustrating visits, we have the nurses well trained (many times we don’t even use a bed or room) and have gotten our average visit down to about an hour.
However, the number of times other patients have complained about our being pushed through as they sit there with their cold or sore finger. We were in there the other night and a guy was there with a sore toe that had started bothering him six months ago…and he bitched about my son (who had a serious bleed - hip joint - wow that is some real pain) getting looked at first. Dont forget the Fat Guy who has a sore back, or the heavy smoker with a cough (and keeps going out in the cold for a smoke - sans coat) or the drunk the police have to bring in,
Fortunately, we are being taught to give the needle ourselves to limit the ER visits. Process is going to be a long one though as they are still quite small and are not the most willing needle recipients.
Honestly though, I think the ER thing is a problem that is very complex for health care. It doesn’t seem to matter, socialized or private, ER is also busy, chaotic and full of moron patients and overwhelmed staff. Some of you do a great job, but I have run into my share of doctors and nurses that need to be thrown out a window. (actually have never had a problem with an imaging person - ultrasound (we get a lot of these) or x-ray (usually ordered by a doctor that doesn’t understand haemophilia and doesn’t listen to me about classic symptoms of a bleed).
It’s not uncommon for us to do them on obese persons in their reproductive years.
So how about this: I get regular quick updates on various practice issues via e-mail, and today’s was about obese women having children with a much higher rate of birth defects. Granted, the focus was on a double (!!!) rate of spina bifida, likely due to folate deficiencies paired w/ undiagnosed diabetes, but it DOES make you wonder…