America & Medi-care

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Supreme Robot
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Re: America & Medi-care

Postby tater » Thu Jan 07, 2010 6:58 pm

The above post is simply wrong WRT to triage. Ability to pay has exactly nothing to do with it. My wife is a surgeon, and she doesn't even know if any given patient has insurance when she sees them. Not the first clue, they are all treated exactly the same, even if they wear orange jumpsuits and show up in handcuffs.

No difference at all in quality of care delivered. When she gets a 3am consult about someone coming in from jail with a self-inflicted problem (you don't EVEN want to know, trust me), I'm the one suggesting (half-asleep) that they just let him die. Nope, 15 minutes later she's getting ready to take the guy to the OR, and I'm stuck in a cold bed.

Triage is not just that the most serious get seen first, but it also depends on the internal logistics. Unless you have an arterial bleed, bleeding is not a "get seen instantly or die" thing. Your wrist vs lacs? There are specialists in an ER. Suture techs sew people up, while the wrist gets seen by different guys. If the ortho guys are idle, and the suture techs are all sewing away, the guys that need stitches are going to wait—sending them to the ortho guys won't help them, they need to get sewed up, and the ortho guys won't be doing that. It's like stuff at night for surgical specialists. It's only an emergency in my wife's mind if the patient won't die, or lose an organ NOW without surgery in the middle of the night (on call). Anything less is NOT emergent, stabilize them, and schedule surgery for nice, daylight hours.

Quality of docs and staff can certainly vary by institution, no question. Such problems are more exaggerated in the major urban areas where they might have a choice to work elsewhere. As it is, State run hospitals literally make pennies on the dollar they bill, they'd not make it a day with out massive subsidy.

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