No Weekend Emergency Ophthalmological Care Available Anywhere in the Region!!!

[Quixote]

I virtually never post on TOTV, but I had something happen yesterday that I’ve been encouraged by my primary care physician to share with TOTVers.

A family member experienced a severe bruise to an eye and as a result was not able to see at all out of that eye—only darkness. Having experienced eye bleeds myself, I knew the potential extreme seriousness of this and the need to find an ophthalmologist—and fast!

I contacted every hospital in the region—first The Villages Regional Hospital, then Leesburg Regional, then both hospitals in Ocala (Ocala Regional and Munroe Regional). I tried urgent care facilities, though probably not all of them. I could not find an ophthalmologist on call on weekends—anywhere! I even contacted my own ophthalmological practice, in whose care I’ve been for many years and where there was a physician on call, but their requirement is that one must be an established patient to be seen on an emergency basis. (I prefer not to name names, and I will deal with this in my own way.)

The only suggestion I was given was “Go to Shands.” I have heard enough stories about patients going to Shands on a weekday for a scheduled appointment and finding no one available! In truth I did not even try calling Shands. Instead I was able to find an ophthalmologist (not in practice in our area) who made himself available more as a favor than anything else.

We are an older population who can easily develop an eye problem spontaneously anytime or bruise ourselves in a myriad of ways that could affect an eye. I don’t mean to be an alarmist, but I feel this is something that Villagers need to be aware of—the lack of availability of ophthalmological care on weekends anywhere within our region!

[graciegirl]

I virtually never post on TOTV, but I had something happen yesterday that I’ve been encouraged by my primary care physician to share with TOTVers.

A family member experienced a severe bruise to an eye and as a result was not able to see at all out of that eye—only darkness. Having experienced eye bleeds myself, I knew the potential extreme seriousness of this and the need to find an ophthalmologist—and fast!

I contacted every hospital in the region—first The Villages Regional Hospital, then Leesburg Regional, then both hospitals in Ocala (Ocala Regional and Munroe Regional). I tried urgent care facilities, though probably not all of them. I could not find an ophthalmologist on call on weekends—anywhere! I even contacted my own ophthalmological practice, in whose care I’ve been for many years and where there was a physician on call, but their requirement is that one must be an established patient to be seen on an emergency basis. (I prefer not to name names, and I will deal with this in my own way.)

The only suggestion I was given was “Go to Shands.” I have heard enough stories about patients going to Shands on a weekday for a scheduled appointment and finding no one available! In truth I did not even try calling Shands. Instead I was able to find an ophthalmologist (not in practice in our area) who made himself available more as a favor than anything else.

We are an older population who can easily develop an eye problem spontaneously anytime or bruise ourselves in a myriad of ways that could affect an eye. I don’t mean to be an alarmist, but I feel this is something that Villagers need to be aware of—the lack of availability of ophthalmological care on weekends anywhere within our region!



Did you try Ocala Eye? I hope the outlook is positive for your family member and I am so sorry for this very stressful turn of events.

[maryanna630]

This is so sad. Even here in San Miguel de Allende Mexico we have several outstanding opthamologists available for emergencies. We want to move to the Villages but certain things are a concern.

[KittyKat]

I can't believe there's not an Opthamologist on call at any of our hospitals. I guess if you have a serious eye injury they Life-flight you to Orlando. Even our small hospital back home had specialists on rotation to take call for something the ER staff couldn't handle. I think I'm going back home to Ohio, snow & all, when my Mom passes. :sigh:

[VT2TV]

I hate to say it, but I am very unhappy with the health care in general in the Villages. I am a nurse, and worked for almost 30 years in a Level 1 Trauma Center where we had every service available 24/7. I know I can't expect that same quality here. But with all of us "oldies" here with numerous health concerns, it seems like we would have more quality care available. If anyone has wonderful doctors for all different health problems, I would be happy to hear them.

[graciegirl]

I hate to say it, but I am very unhappy with the health care in general in the Villages. I am a nurse, and worked for almost 30 years in a Level 1 Trauma Center where we had every service available 24/7. I know I can't expect that same quality here. But with all of us "oldies" here with numerous health concerns, it seems like we would have more quality care available. If anyone has wonderful doctors for all different health problems, I would be happy to hear them.



I understand your feelings about the health care here. In general I miss Cincinnati where we previously lived. Of course Cincinnati was a much bigger area with the excellent University of Cincinnati Medical School.


The problem lies in how to attract physicians of the kind of experience you speak of.


The expansion of the Villages Hospital's size is in the works but I don't know if it will help. I think that most of us being on medicare may be a minus, and the future changes due to the new health care law may not be good either. That is JUST my unsubstantiated opinion at this time and it can be changed.


That said I have an excellent endocrinologist, Dr. Fish. There are some well trained opthamologists with Ocala Eye. I am satisfied with Dr. Casper as a dermatologist, but the jury is still out on our PCP. We have switched once and may switch again.

[Living a Fantasy]

A couple of years ago, I had cataracts and had a need to call at 2:00am and spoke to the opthamologist on call almost immediately. Not sure if you needed to be a patient of the practice.

[justjim]

OP, Iam not surprised that your family member needs couldn't be met locally or in Ocala. I suppose Orlando would be the closest next best place for such a specialist.

I believe the "Villages Health Care System" is quite aware of the shortcoming regarding various Specialists and is working on the problem---of course---although that is good---it doesn't help much now.

I hope your family member has a quick recovery.

[ilovetv]

Since there are two sides to every story, and I've seen how hard and long my ophthalmologist works in the office after doing early morning surgeries, rounds, etc., I looked around to see what is said about being on-call for the hospital.

This article linked below and others talk about this "national problem" for drs. in community hospitals that do not have residents in training on call.

It didn't take long to find out that on-call specialists are most likely going to go unpaid when being awakened from sleep and having to go to the hospital in the middle of the night to work on an unknown patient and then travel home to try to grab a couple more hours of sleep so they can do their best for their patients in surgery and office consults the next day.

Personally, I would not want my airline captain being awakened at 1 a.m. and told to go to the airport to work on a plane of unknown origin for 1-2 hours and then drive back home/hotel to bed at 3:00 a.m., when he has to get up and be at his best to fly 200 passengers at 6:00 a.m.

The same goes for my eye surgeon.


Then, to add insult to injury, articles and readers report that the dr. specialist on call is more likely to be sued by random patients they don't know but have to treat in the night, so they have to do lots of legal documentation CYA with call patients who don't show up for followup and are non-compliant with their treatment.

The reader comments from drs. are especially revealing. These two said it well:


I am still on call for assigned outpatients from ER call. At least 80% of them are self pay or Medicaid. The rest are noncompliant insured patients. Many of them fail to show up for the follow up visit and about 5-10% of them have abnormal labs that need follow up. I then have to look up their demographics at the hospital, attempt to call the person and send a certified letter with the abnormal information. I have to recommend that they follow up with a physician somewhere, just to lower my liability risks. It gets old dealing with abnormal glucose, STDs, + drug screens, abnormal CTs or CXRs. It actually costs me money and time to deal with these free follow up patients.

Greg • 3 years ago
Good post highlighting a problem that most of the public has no idea exists.

Part of the problem for specialists taking call is that providing pro-bono care isn't free. Even if a specialist is willing to give up his/her sleep night after night, and is willing to work without pay (already a combination most non-doctor workers in America would refuse outright), he/she is still liable for any litigation which results from their services. So even if they spend a sleepless night working for free, they may still lose their shirt if sued for malpractice. It's difficult to be altruistic to those who may harm you; it's possible, but takes a Dalai Lama-esqe sense of compassion to pull off, and is therefore pretty rare. As a result, even altruistic specialists are turned off from night call, and the problem only gets worse.


imdoc Greg • 3 years ago
And, of course, if an untoward event does occur after many hours of work doing your duty to cover the ER, the plaintiff attorney will use it against you to imply that fatigue undermined your abilities at the time.


Smart Doc imdoc • 3 years ago
Yup, the lawyers will 100% attack you on that basis.

No liabilty for ER slave duty. Emergent care must be made exempt from liabilty charges.


See Article: Fewer physicians are taking call in rural emergency rooms (http://www.kevinmd.com/blog/2011/02/physicians-call-rural-emergency-rooms.html)

[emc101]

we are from nj. 1 hour from Philadelphia. even local hospitals had emergency eye care.

I have found doctors here lacking that's why we will not move down here year around. we stay here from jan to may . in jersey for drs. from may to sept. back again to see them in dec.

until they get better drs. will never come here all year. have only found decent dr for skin and husbands cpap. others forget it

[Bogie Shooter]

This is so sad. Even here in San Miguel de Allende Mexico we have several outstanding opthamologists available for emergencies. We want to move to the Villages but certain things are a concern.

///

[DEWRDW]

I virtually never post on TOTV, but I had something happen yesterday that I’ve been encouraged by my primary care physician to share with TOTVers.

A family member experienced a severe bruise to an eye and as a result was not able to see at all out of that eye—only darkness. Having experienced eye bleeds myself, I knew the potential extreme seriousness of this and the need to find an ophthalmologist—and fast!

I contacted every hospital in the region—first The Villages Regional Hospital, then Leesburg Regional, then both hospitals in Ocala (Ocala Regional and Munroe Regional). I tried urgent care facilities, though probably not all of them. I could not find an ophthalmologist on call on weekends—anywhere! I even contacted my own ophthalmological practice, in whose care I’ve been for many years and where there was a physician on call, but their requirement is that one must be an established patient to be seen on an emergency basis. (I prefer not to name names, and I will deal with this in my own way.)

The only suggestion I was given was “Go to Shands.” I have heard enough stories about patients going to Shands on a weekday for a scheduled appointment and finding no one available! In truth I did not even try calling Shands. Instead I was able to find an ophthalmologist (not in practice in our area) who made himself available more as a favor than anything else.

We are an older population who can easily develop an eye problem spontaneously anytime or bruise ourselves in a myriad of ways that could affect an eye. I don’t mean to be an alarmist, but I feel this is something that Villagers need to be aware of—the lack of availability of ophthalmological care on weekends anywhere within our region!

I went to urgent care affliated with the Villages Hospital when I accidentally stuck a straw branch in my eye when making a floral arrangement - the doctor there looked to see if there was any damage to the eye beside the stratch that the branch left - I was given a script for eye medication and within a week my eye was fine - I was told to go to an ophthamologist if need be but the medication took care of it - this was on a Sunday!

[rubicon]

I hate to say it, but I am very unhappy with the health care in general in the Villages. I am a nurse, and worked for almost 30 years in a Level 1 Trauma Center where we had every service available 24/7. I know I can't expect that same quality here. But with all of us "oldies" here with numerous health concerns, it seems like we would have more quality care available. If anyone has wonderful doctors for all different health problems, I would be happy to hear them.

HI VIT2TV: I have the same view especially coming from an excellent health care state as Minnesota and the Minneapolis area.

Do you have a fix as to why it is so problematic here. We have a majority older age group that would support such elder care specialties and with medicare and having medicare supplements

[BarryRX]

I have similiar thoughts about going to Mexico. What with all the drug gangs and murders happening there.

You have made an unfair generalization about San Miguel de Allende. Mexico is a very big country and this town is far from the "border" troubles. In fact, it is a lovely place and has lots of retired Americans living there. No need to lash out because someone thinks the healthcare in the area is lagging behind the population growth.

[Bogie Shooter]

///

[maryanna630]

Thanks BarryRx for the support. What can you say when someone replies with such ignorance. I don't get the point.

[Quixote]

Now, a couple of days past the stress of dealing with a family member's eye injury (which is healing though very slowly), I'm beginning to wonder what other specialties have no one on call nights and weekends in our region. Not a reassuring thought....

[VT2TV]

HI VIT2TV: I have the same view especially coming from an excellent health care state as Minnesota and the Minneapolis area.

Do you have a fix as to why it is so problematic here. We have a majority older age group that would support such elder care specialties and with medicare and having medicare supplements


Hi, I am afraid that the fact that a large number of us are on Medicare is causing us problems. Medicare has such poor reimbursement to the physicians, and a lot of doctors don't want to or can't afford to take mostly Medicare patients, especially a lot of the younger ones who may still have huge college loans to pay. I am not trying to stir up anything here, but I was told by many medical school students that 20+years ago, there was a large number of foreign students who were given free or largely free tuition to medical schools in the US because colleges were trying to show diversity . Is that the reason we have so many doctors here who weren't born in this country???? I truly don't know. But I am on my second primary doctor, and am thinking about changing again. I am also afraid that with the Affordable Care Act, things are going to get a whole lot worse before it gets better-if at all. (esp. for seniors) No flames please anyone. This is my OPINION, and it is fine if people don't agree with me.

[George1938]

who is the cpap doctor?

[graciegirl]

who is the cpap doctor?


Would that be pulmonary specialist? I would like to know if there is a good one here. I don't know which one my dear friend went to here having terrible breathing difficulty (She was a snowbird and having her chemo administered here on orders from her Chicago oncologist) but when she returned to Chicago her oncologist found that he had failed to see that it was due to her heart being damaged by the chemo she was on and switched her over.


I think that doctor here should have checked for that. I would like to consult a pulmonary specialist due to my scoliosis, but hesitate, not knowing which one she used. Ruthie has passed.

[tommy steam]

Thinking about emergency eye care. I will contact my eye care group and ask how they treat an emergency situation after working hours. I may never need it but I would like to know just in case.

[Bizdoc]

Finding "on call" specialists is always problematic when you don't have teaching hospitals (hospitals with interns and residents). As the insurance companies pushed for more and more day surgery, the rationale for doctors to maintain privileges at hospitals (and the required on call days that come with it as well as costs) led docs to stop doing surgery in hospitals and do it in their own clinics instead. If you look at the local ophthalmologists, all do surgeries in their own offices/clinics. And the hospitals don't want docs who don't bring them business working at their hospital.

I knew an oral surgeon whose wife got fed up with the unpaid bills (over 90%) of "after hours patients" who started going in with her hubby and collaring the patients family to pay while her husband worked on the person. Still collected less than 50% of bills due.

[dillywho]

we are from nj. 1 hour from Philadelphia. even local hospitals had emergency eye care.

I have found doctors here lacking that's why we will not move down here year around. we stay here from jan to may . in jersey for drs. from may to sept. back again to see them in dec.

until they get better drs. will never come here all year. have only found decent dr for skin and husbands cpap. others forget it

I'm sorry, but your generalizations do not hold water. Unless you have seen every single physician in the entire area, how can you possibly say that none of them are any good? That is the same as saying there are no good mechanics, clothing stores, hardware stores, restaurants, grocery stores, barbers and hairdressers, etc.

Not every doctor can possibly be at the place where you describe. Are there bad apples here? Sure. Are there bad apples there? You betcha. You were apparently fortunate enough not to encounter one.

My whole point is: One cannot lump everyone, whether it is a physician or mechanic or whatever into one category. My husband is alive and still with me because of the EXCELLENT skill of the doctors HERE, and for that I am eternally grateful. We definitely do not get all the "culls".

[ilovetv]

Finding "on call" specialists is always problematic when you don't have teaching hospitals (hospitals with interns and residents). As the insurance companies pushed for more and more day surgery, the rationale for doctors to maintain privileges at hospitals (and the required on call days that come with it as well as costs) led docs to stop doing surgery in hospitals and do it in their own clinics instead. If you look at the local ophthalmologists, all do surgeries in their own offices/clinics. And the hospitals don't want docs who don't bring them business working at their hospital.

I knew an oral surgeon whose wife got fed up with the unpaid bills (over 90%) of "after hours patients" who started going in with her hubby and collaring the patients family to pay while her husband worked on the person. Still collected less than 50% of bills due.

And THAT is "where the rubber meets the road"!

[rn1tv]

ilovetv, to my knowledge, no ophthalmologists go to TVRH, they all pulled out sometime again and use their own surgery centers. I retired RN from TVRH and recently had to have cataract surgery under the hospital's insurance. It would have been a lot cheaper for me if I could have had it done at TVRH. Not sure why they all pulled out...probably more $ in their pockets!
In response to your comment on how busy the ophthalmologists are in their practice, how about the surgeon who performed complicated surgeries all day but are on-call for emergencies and called back in the middle of the night for an emergency appendectomy? Just know there are docs on call at the hospitals, just not ophthalmologists at TVRH. I, too, hope the availability at our local hospitals increases!