Tvrh - er 5 hour wait

[Diva Kay]

I was sent straight from Lake Center Imaging to ER as I had a blood clot in my right leg - yes a life threatening blood clot.
Do you know they sat me in a wheelchair for 5 hours before ever seeing a doctor. The ER is for emergency situations and trust me a blood clot is an emergency.

Then the doctor admitted me - and guess what, I was sent somewhere in the dark ages of the hospital - a semi private room with a port-a-potty. And the woman in the other bed had bronchial pneumonia - very contagious!

So....if you are following this....I have a life threatening condition and my life is further threatened by bronchial pneumonia.
AND, where are these beautiful private rooms that millions of dollars were spent on?????

[Jima64]

that is scary. what were they thinking or were they too busy with other emergencies?

[Railcruiser]

Porta potty because you should be on bed rest. The rest inexcusable

[Diva Kay]

Bed pan because of bed rest. Port-a-potty was for mobile people like the chronic lady next to me. I was told there were 28 treatments rooms, all full, and only 2 doctors.

[linday]

My mom developed double pneumonia and was sent to er from premier medical and waited 9 hours before getting room and treatment. Mom got better thank God! But, have been advised in the future to only go to the villages hospital by ambulance or it may be your last hospital stay ever! Unacceptable!

[golfing eagles]

I was sent straight from Lake Center Imaging to ER as I had a blood clot in my right leg - yes a life threatening blood clot.
Do you know they sat me in a wheelchair for 5 hours before ever seeing a doctor. The ER is for emergency situations and trust me a blood clot is an emergency.

Then the doctor admitted me - and guess what, I was sent somewhere in the dark ages of the hospital - a semi private room with a port-a-potty. And the woman in the other bed had bronchial pneumonia - very contagious!

So....if you are following this....I have a life threatening condition and my life is further threatened by bronchial pneumonia.
AND, where are these beautiful private rooms that millions of dollars were spent on?????

Sorry, but I have to throw my 2 cents in on this one. I don't doubt you perceived the situation as you described, but to give an independent opinion:

1) A venous thrombus in the leg is not life threatening, it only has that potential if a piece breaks off, travels downstream, and causes a pulmonary embolus. I have seen people walk around for weeks with a DVT and only come in to be seen because their leg was swollen.

2) I personally see no excuse for a 5 hour wait. It sounds like the ER physician already knew the story---I assume you were at the imaging center for a venous Doppler which was positive, and that's why they sent you to the ER. If I were the ER doc, I would want to shoot you up with lovenox ASAP, it would take about 3 minutes to introduce myself, poke on your leg and start treatment. Imagine how everyone would feel if at hour 4 you developed respiratory distress and pleuritic chest pain consistent with an embolus and no one had even seen you.
On the other hand, last October I was sent to the ER at Strong Memorial for emergency neurosurgery, which was done after 22 hours in the ER

3) If you had uncomplicated DVT with no co-morbidities, you didn't even need to be admitted. Just start lovenox in the ER, give you a prescription for Xarelto, and have your physician check you in 3 days, possibly repeating the venous Doppler

4) Bedrest???? I think the last time that was ordered for a DVT was 1956

5) Bacterial pneumonia is not VERY contagious. Most of the bacteria that cause it are already present in your own respiratory tract---it is only when conditions are right that it can take over and cause pneumonia (chronic lung disease, malnutrition, immunocompromised, diabetes, etc.). If it were highly contagious, hospitals would be required to place all pneumonia patients in isolation

6) There is a lot of trashing TVRH on TOTV, not saying that was what you were doing. But my wife was admitted there in March. Yes , she had a 6 hour ER wait, and yes, her condition WAS life threatening. She was there 16 days then across the street in rehab for another 26 days. Was this the best hospital in the world---no. Was it the worst--certainly not, I've seen some of the worst. Having had experience with about 3 dozen hospitals up north, I would put it the 40th percentile---which really is not too bad for what it is. We should be thankful for what we have, and in case everyone hasn't realized it yet, healthcare in the US is about to take a nosedive

[justjim]

"Healthcare in the United States is about to take a nosedive". What do you base this statement on? Shortage of doctors and nurses plus an aging population? Perhaps Obamacare? If this is factual, why aren't we doing something about it? Just wondering.....

[Bonnevie]

"Healthcare in the United States is about to take a nosedive". What do you base this statement on? Shortage of doctors and nurses plus an aging population? Perhaps Obamacare? If this is factual, why aren't we doing something about it? Just wondering.....

my two cents---because it costs money! medicare keeps cutting reimbursements to doctors and hospitals. staffs are cut to save money. the smartest people don't see becoming a doctor as a good return on their considerable investment of time and money. everyone is doing more with less and yet patients are demanding more and better but don't want to make lifestyle changes for their health. just watch tv--don't modify your diet, take Nexium or a statin. costs are skyrocketing.

[golfing eagles]

"Healthcare in the United States is about to take a nosedive". What do you base this statement on? Shortage of doctors and nurses plus an aging population? Perhaps Obamacare? If this is factual, why aren't we doing something about it? Just wondering.....

It's just my opinion, but here is my basis:

1) there is a growing shortage of doctors, especially in primary care. If the Obamacare dream of covering everyone comes to fruition, that's 40+ million more patients in need of primary care with less doctors

2) When I first started medical school in 1978, there were 129,000 American applicants for 17,000 seats. Last I saw numbers about 6 years ago, there were 23,000 applicants for the same 17K seats. Due to a variety of economic and social changes, the talent pool is being diluted, and therefore the "average" physician probably starts out with lower qualifications than in the past.

3) Our residency programs cannot fill with American graduates, therefore the programs are getting filled with FMGs, 5th pathway graduates, and previous practitioners from abroad. Some are good, some are not.

4) Medicare is going bankrupt, some insurers are dropping out of the medicare market, and the cost keeps going up. Add to that the cost of 40+ million new "insurees" that for the most part are subsidized, the cost of advanced technology, the aging of the baby boomers, and the unfunded liabilities of Obamacare. This means either raising taxes to pay for all this, or the dreaded "R" word---rationing health care like they do in Europe. I'm not sure Americans will stand for either.

5) Probably nothing is being done because no one knows what to do, or no one can agree on it, or the issue is too politically charged for any elected official to want to take the lead on it

6) I'm not sure some, if not all of this has been scripted to cause a collapse of our healthcare system so as to carve a path for the Holy Grail of the left---socialized medicine, which is gaining popularity with younger voters anyway. I hope they eventually realized that "Medicare for All" really means VA style healthcare for all, with the attendant triple the cost bureaucracy and one third the efficiency of all government programs. The system would work much better as a benign dictatorship, as long as I am the dictator:1rotfl::1rotfl::1rotfl:

[Bogie Shooter]

///

[golfing eagles]

my two cents---because it costs money! medicare keeps cutting reimbursements to doctors and hospitals. staffs are cut to save money. the smartest people don't see becoming a doctor as a good return on their considerable investment of time and money. everyone is doing more with less and yet patients are demanding more and better but don't want to make lifestyle changes for their health. just watch tv--don't modify your diet, take Nexium or a statin. costs are skyrocketing.

You are basically correct. Medicare has been giving doctors a 1-2% fee increase for the last 8-10 years, but costs go up 4-5% per year. Hospitals are worse off because of complex regulations that actually take back some of the money that was paid to them. Since hospitals are labor intensive, that is where the cuts are made. Less of our brightest young people are attracted to medicine due to the years involved, the huge loans they need, and the constant threat of litigation, as well as a media that seems to continually portray doctors in a negative light----you hear about the huge malpractice award, or the license revocation, but not the tens of millions of beneficial encounters.
As far as patient compliance goes, Klatu (The Day the Earth Stood Still) put it best when he said "People do not change until they are on the precipice" The health conscious among us already eat right and exercise, but most of the rest won't change until they have a heart attack, or a diabetic complication

[NYGUY]

It's just my opinion, but here is my basis:

1) there is a growing shortage of doctors, especially in primary care. If the Obamacare dream of covering everyone comes to fruition, that's 40+ million more patients in need of primary care with less doctors

2) When I first started medical school in 1978, there were 129,000 American applicants for 17,000 seats. Last I saw numbers about 6 years ago, there were 23,000 applicants for the same 17K seats. Due to a variety of economic and social changes, the talent pool is being diluted, and therefore the "average" physician probably starts out with lower qualifications than in the past.

3) Our residency programs cannot fill with American graduates, therefore the programs are getting filled with FMGs, 5th pathway graduates, and previous practitioners from abroad. Some are good, some are not.

4) Medicare is going bankrupt, some insurers are dropping out of the medicare market, and the cost keeps going up. Add to that the cost of 40+ million new "insurees" that for the most part are subsidized, the cost of advanced technology, the aging of the baby boomers, and the unfunded liabilities of Obamacare. This means either raising taxes to pay for all this, or the dreaded "R" word---rationing health care like they do in Europe. I'm not sure Americans will stand for either.

5) Probably nothing is being done because no one knows what to do, or no one can agree on it, or the issue is too politically charged for any elected official to want to take the lead on it

6) I'm not sure some, if not all of this has been scripted to cause a collapse of our healthcare system so as to carve a path for the Holy Grail of the left---socialized medicine, which is gaining popularity with younger voters anyway. I hope they eventually realized that "Medicare for All" really means VA style healthcare for all, with the attendant triple the cost bureaucracy and one third the efficiency of all government programs. The system would work much better as a benign dictatorship, as long as I am the dictator:1rotfl::1rotfl::1rotfl:

Good analysis!!

[Diva Kay]

I do appreciate all comments; however, when your leg is swelled up so bad that it hurts to walk on it and your sandal has to be cut off - I was in no position to question anything the ER doctor told me.

[golfing eagles]

I do appreciate all comments; however, when your leg is swelled up so bad that it hurts to walk on it and your sandal has to be cut off - I was in no position to question anything the ER doctor told me.

Didn't mean to minimize your symptoms, I know it sucks and hurts a lot. Was just offering an opinion on the standard treatment for uncomplicated DVT and whether it is immediately life threatening. Best wishes for a speedy recovery.:)

[SoccerCoach]

Didn't mean to minimize your symptoms, I know it sucks and hurts a lot. Was just offering an opinion on the standard treatment for uncomplicated DVT and whether it is immediately life threatening. Best wishes for a speedy recovery.:)

Your replies here are spot on. We entered the ER Tuesday Morning at 3 a.m., in pain. Registered, saw the triage nurse in 40 minutes. Waited another short while until a bed was available. Moved to a bed, preliminaries performed, seen by the doctor who was there at 5:30, cat scan at 6. Given pain med, rested until cat scan results proved nothing serious, leaving us with just a painful discomfort which was now subsiding. Discharged with prescription at 8 a.m. All things considered, a somewhat uncomfortable but efficient and professional experience.

[MrGolf]

Excellent analysis and assessment. Many times you hear things need to get worse before they get better. I am afraid the first part is true but not so sure about the second part.

[billethkid]

Beware the establishments that have a huge red stamp that says "Medicare Patient".

Back of the line bottom of the list......then high speed shuffle.

One does not see "Blue Cross/Blue shield" patient or any other.

Any other rationale why they have to stamp the page with so obvious an identification?

[golfing eagles]

Beware the establishments that have a huge red stamp that says "Medicare Patient".

Back of the line bottom of the list......then high speed shuffle.

One does not see "Blue Cross/Blue shield" patient or any other.

Any other rationale why they have to stamp the page with so obvious an identification?


Seriously?????

Who does that?????

In 35 years I've never seen that or even heard of it. Furthermore, no healthcare provider in a hospital setting is the least bit concerned about what type of insurance a patient has---could it have had some administrative meaning?????

[Nursebarb1]

I retired as an RN in 2009. I never knew the patient's method of payment, and I am proud to say that it never would have compromised my care, or any other nurse I worked with.

[rubicon]

It's just my opinion, but here is my basis:

1) there is a growing shortage of doctors, especially in primary care. If the Obamacare dream of covering everyone comes to fruition, that's 40+ million more patients in need of primary care with less doctors

2) When I first started medical school in 1978, there were 129,000 American applicants for 17,000 seats. Last I saw numbers about 6 years ago, there were 23,000 applicants for the same 17K seats. Due to a variety of economic and social changes, the talent pool is being diluted, and therefore the "average" physician probably starts out with lower qualifications than in the past.

3) Our residency programs cannot fill with American graduates, therefore the programs are getting filled with FMGs, 5th pathway graduates, and previous practitioners from abroad. Some are good, some are not.

4) Medicare is going bankrupt, some insurers are dropping out of the medicare market, and the cost keeps going up. Add to that the cost of 40+ million new "insurees" that for the most part are subsidized, the cost of advanced technology, the aging of the baby boomers, and the unfunded liabilities of Obamacare. This means either raising taxes to pay for all this, or the dreaded "R" word---rationing health care like they do in Europe. I'm not sure Americans will stand for either.

5) Probably nothing is being done because no one knows what to do, or no one can agree on it, or the issue is too politically charged for any elected official to want to take the lead on it

6) I'm not sure some, if not all of this has been scripted to cause a collapse of our healthcare system so as to carve a path for the Holy Grail of the left---socialized medicine, which is gaining popularity with younger voters anyway. I hope they eventually realized that "Medicare for All" really means VA style healthcare for all, with the attendant triple the cost bureaucracy and one third the efficiency of all government programs. The system would work much better as a benign dictatorship, as long as I am the dictator:1rotfl::1rotfl::1rotfl:

spot on and don't forget the piles upon piles of regulations and reporting required of doctors from the government and insurance companies

[skip0358]

Yes the Emergency Room gets backed up just about all the time. Can't be refused treatment so people go there period. Had to take our Granddaughter there the other night. Asthma attack. Walked in , filled out the paperwork and she was brought in and treatment was started end of story. While we were waiting for her I saw a ton of walking wounded as we called them when I rode the Ambulance come in didn't look any sicker then I was. Some watched TV some ate & drank coffee, some took a nap, others I think came in for the Air Conditioning. My point this bogs down the ER period. So yep an other patient coming in who may really have a problem has to wait. Others try the old call an Ambulance trick, if their not down & out enough they to go and sit for long periods of time. Sometimes it just sucks more being sick.

[golfing eagles]

Yes the Emergency Room gets backed up just about all the time. Can't be refused treatment so people go there period. Had to take our Granddaughter there the other night. Asthma attack. Walked in , filled out the paperwork and she was brought in and treatment was started end of story. While we were waiting for her I saw a ton of walking wounded as we called them when I rode the Ambulance come in didn't look any sicker then I was. Some watched TV some ate & drank coffee, some took a nap, others I think came in for the Air Conditioning. My point this bogs down the ER period. So yep an other patient coming in who may really have a problem has to wait. Others try the old call an Ambulance trick, if their not down & out enough they to go and sit for long periods of time. Sometimes it just sucks more being sick.


You are correct. A patient can only see what they can see----that is a full waiting room with people sitting around, some people who come after them getting seen first, and a whole bunch complaining about the wait. This is not a first come, first serve situation. About 1/2 the people in that ER waiting room are accompanying a patient, not one themselves. When you tell the receptionist your problem, there is an immediate preliminary triage that shows on the nurses' computer screen. You then see a RN who does a full triage, which the physician uses to prioritize cases. To the casual observer, it looks like nothing is happening, but in reality each patient is already in a queue and probably the ER doc has developed a preliminary plan to evaluate the patient.

When my wife was there in March, there were about 17 patients and a total of about 30 people in the waiting room. Glancing around (and this is just a guesstimate) my impression was that I could treat 15 of the 17 in my office, 1 at urgent care, and the 1 remaining patient was a close enough call to justify her presence. I have no idea of the severity of the illnesses that were already in an ER room.

Also, at least in NY, it was cheaper for a Medicaid patient to take an $800 ambulance ride to the ER than to call a $6 car service, so emergency vehicles were being abused for $3. We eventually fixed some of this by having ambulance crews with non-urgent cases take the patient to the waiting room and register as if they walked in

[CFrance]

You are correct. A patient can only see what they can see----that is a full waiting room with people sitting around, some people who come after them getting seen first, and a whole bunch complaining about the wait. This is not a first come, first serve situation. About 1/2 the people in that ER waiting room are accompanying a patient, not one themselves. When you tell the receptionist your problem, there is an immediate preliminary triage that shows on the nurses' computer screen. You then see a RN who does a full triage, which the physician uses to prioritize cases. To the casual observer, it looks like nothing is happening, but in reality each patient is already in a queue and probably the ER doc has developed a preliminary plan to evaluate the patient.

When my wife was there in March, there were about 17 patients and a total of about 30 people in the waiting room. Glancing around (and this is just a guesstimate) my impression was that I could treat 15 of the 17 in my office, 1 at urgent care, and the 1 remaining patient was a close enough call to justify her presence. I have no idea of the severity of the illnesses that were already in an ER room.

Also, at least in NY, it was cheaper for a Medicaid patient to take an $800 ambulance ride to the ER than to call a $6 car service, so emergency vehicles were being abused for $3. We eventually fixed some of this by having ambulance crews with non-urgent cases take the patient to the waiting room and register as if they walked in
GE, with all due respect to your knowledge... If only everyone were a doctor and could diagnose the severity of his own illness/emergency. Or if only (and maybe they did; OP didn't say) the doctors and nurses communicated every single thing in your original reply to her to ease her fears over her condition and the degree of contagiousness of her roommate. The latter may not be possible due to time constraints, but somewhere along the line somebody must have had enough time to convey that information. Or they should make the time, since 16 out of 17 patients, using your experience as a for-instance, in an ER aren't in life-threatening conditions.

[blueash]

It's just my opinion, but here is my basis:

1) there is a growing shortage of doctors, especially in primary care. If the Obamacare dream of covering everyone comes to fruition, that's 40+ million more patients in need of primary care with less doctors

2) When I first started medical school in 1978, there were 129,000 American applicants for 17,000 seats. Last I saw numbers about 6 years ago, there were 23,000 applicants for the same 17K seats. Due to a variety of economic and social changes, the talent pool is being diluted, and therefore the "average" physician probably starts out with lower qualifications than in the past.

3) Our residency programs cannot fill with American graduates, therefore the programs are getting filled with FMGs, 5th pathway graduates, and previous practitioners from abroad. Some are good, some are not.

4) Medicare is going bankrupt, some insurers are dropping out of the medicare market, and the cost keeps going up. Add to that the cost of 40+ million new "insurees" that for the most part are subsidized, the cost of advanced technology, the aging of the baby boomers, and the unfunded liabilities of Obamacare. This means either raising taxes to pay for all this, or the dreaded "R" word---rationing health care like they do in Europe. I'm not sure Americans will stand for either.

5) Probably nothing is being done because no one knows what to do, or no one can agree on it, or the issue is too politically charged for any elected official to want to take the lead on it

6) I'm not sure some, if not all of this has been scripted to cause a collapse of our healthcare system ...:

Lots of opinions and a couple of "facts" upon which those opinions were formed.
Easiest to fact check, how many applicants were there for medical schools in 1978? was is 129000 US applicants? Not even close. In 1978 there were under 30,000 applicants. The last year reported in 2014 had the highest number of applicants in history.
Medical School Applicants, Enrollment Reach All-time Highs - News Releases - Newsroom - AAMC (https://www.aamc.org/newsroom/newsreleases/358410/20131024.html)
Medical School Applicants, Enrollees Reach New Highs - News Releases - Newsroom - AAMC (https://www.aamc.org/newsroom/newsreleases/446400/applicant-and-enrollment-data.html)

Long term trends are here up to 2002 Medical Schools And Their Applicants: An Analysis (http://content.healthaffairs.org/content/22/4/71.full%3Fmaxtoshow%3D%26HITS%3D10%26hits%3D10%26R ESULTFORMAT%3D%26author1%3Drichard%2Bcooper%26full text%3Dphysician%2Bworkforce%26andorexactfulltext% 3Dand%26searchid%3D1%26FIRSTINDEX%3D0%26resourcety pe%3DHWCIT)

So that fact is in error by a huge amount.
Primary care providers no longer means physicians. An increase of 10% in the number of insured lives means that all else being equal, you need 10% more primary providers. This requirement is likely to be met by advanced practice nurses and PA's in large part, freeing the more highly trained MD's and DO's to handle the non-routine patient care.

In 1965 23% of residency positions were filled by foreign medical graduates
Foreign Medical Graduates in the United States - Harold Margulies, Lucille Stephenson Bloch - Google Books (https://books.google.com/books?id=I-gyaLFBtaAC&pg=PA9&lpg=PA9&dq=what+percent+of+medical+residency+filled+by+fmg&source=bl&ots=Ax4OryEzG7&sig=iODCUy9NJhcUOrgwMG2G4DJT-ro&hl=en&sa=X&ved=0ahUKEwjVneylrd_NAhWElx4KHRcrA70Q6AEIYTAJ#v=on epage&q=what%20percent%20of%20medical%20residency%20fill ed%20by%20fmg&f=false)
and it is 21% now
Medscape: Medscape Access (http://www.medscape.com/viewarticle/857443)

When you start with non-factual facts, you might end up with non-reasonable conclusions, or not

As to what we Americans will stand for, that is for the political forum but to suggest that there is some secret conspiracy of people attempting to collapse the health care industry is ....

[rubicon]

I question whether the average person who is experiencing acute pain, feeling disoriented etc cares one bit about politics or statistics. I believe most follow the education provided by health organizations that suggest if you are experiencing.....then better get to a health provider. ( see below) And further, I'll bet most people are aware of the old adage that warns "he who doctors himself has a fool for a patient" ( see below). I have a perfect and personal example of how ER failed me badly and ran up a $6,000 + bill for nothing but to what avail. I also have a perfect and personal example of why going to an urgent care failed and cost me some permanency but again to what avail.

So as referenced above rather than blame people with no medical training for going to the ER why doesn't the ER use their triage skills and separate the ER cases from the urgent care people?

[golfing eagles]

Lots of opinions and a couple of "facts" upon which those opinions were formed.
Easiest to fact check, how many applicants were there for medical schools in 1978? was is 129000 US applicants? Not even close. In 1978 there were under 30,000 applicants. The last year reported in 2014 had the highest number of applicants in history.
Medical School Applicants, Enrollment Reach All-time Highs - News Releases - Newsroom - AAMC (https://www.aamc.org/newsroom/newsreleases/358410/20131024.html)
Medical School Applicants, Enrollees Reach New Highs - News Releases - Newsroom - AAMC (https://www.aamc.org/newsroom/newsreleases/446400/applicant-and-enrollment-data.html)

Long term trends are here up to 2002 Medical Schools And Their Applicants: An Analysis (http://content.healthaffairs.org/content/22/4/71.full%3Fmaxtoshow%3D%26HITS%3D10%26hits%3D10%26R ESULTFORMAT%3D%26author1%3Drichard%2Bcooper%26full text%3Dphysician%2Bworkforce%26andorexactfulltext% 3Dand%26searchid%3D1%26FIRSTINDEX%3D0%26resourcety pe%3DHWCIT)

So that fact is in error by a huge amount.
Primary care providers no longer means physicians. An increase of 10% in the number of insured lives means that all else being equal, you need 10% more primary providers. This requirement is likely to be met by advanced practice nurses and PA's in large part, freeing the more highly trained MD's and DO's to handle the non-routine patient care.

In 1965 23% of residency positions were filled by foreign medical graduates
Foreign Medical Graduates in the United States - Harold Margulies, Lucille Stephenson Bloch - Google Books (https://books.google.com/books?id=I-gyaLFBtaAC&pg=PA9&lpg=PA9&dq=what+percent+of+medical+residency+filled+by+fmg&source=bl&ots=Ax4OryEzG7&sig=iODCUy9NJhcUOrgwMG2G4DJT-ro&hl=en&sa=X&ved=0ahUKEwjVneylrd_NAhWElx4KHRcrA70Q6AEIYTAJ#v=on epage&q=what%20percent%20of%20medical%20residency%20fill ed%20by%20fmg&f=false)
and it is 21% now
Medscape: Medscape Access (http://www.medscape.com/viewarticle/857443)

When you start with non-factual facts, you might end up with non-reasonable conclusions, or not

As to what we Americans will stand for, that is for the political forum but to suggest that there is some secret conspiracy of people attempting to collapse the health care industry is ....

Thank you for the update---my info is about 10-12 years old.
The 129,000 number was just what we were told in 1978, it may have included non-US citizens, or been inflated to emphasize the competitiveness of the process, so my apologies
According to your own citation, medical school applicants dropped from 47,000 to 32,000 from 1996 to 2003--but yes, those numbers have since rebounded
It did not state whether "residency programs" also included fellowship programs. Since many fellowships went from 2 to 3 years, the number finishing each year declined by 33%. In addition, about 50% of medical school graduates are now women, and that is great---however, women physicians tend to work less hours and have career interruptions for maternity leave, numbers alone don't tell the whole story

I still question the qualifications of new applicants. MCAT scores have declined. The pass rate on NBME pat I is now down to 85%---a test that my dog could pass( yes, that's a hyperbole). I sat on the admissions committee at SUNY and we had applicants with 2.3 GPAs and 35 on the MCATs---so not all "applicants" are created equal

Now, that takes care of new physicians, and your numbers are accepted. It does not include the accelerated attrition of existing physicians. The AMA estimated that as many as 250,000 current clinical MDs out of 900,000 will be lost to alternative careers and early retirement over the next 5 years. And the demand will only go up. In addition, more physician time is spent on documentation and regulation, so the number of hours in direct patient care has declined, per physician

I love nurse practitioners, but there is a pitfall there also. NPs, on average , will order far more lab tests and imaging procedures for the same condition than an experienced MD would. This drives up cost. They do spend more time with each patient, but therefore see less numbers, so you cannot substitute them for MDs 1 for 1.

So regardless of some of my inaccurate or out of date numbers, I stand by my opinion that the quality of medical in the US is going to go down, not up.

[golfing eagles]

GE, with all due respect to your knowledge... If only everyone were a doctor and could diagnose the severity of his own illness/emergency. Or if only (and maybe they did; OP didn't say) the doctors and nurses communicated every single thing in your original reply to her to ease her fears over her condition and the degree of contagiousness of her roommate. The latter may not be possible due to time constraints, but somewhere along the line somebody must have had enough time to convey that information. Or they should make the time, since 16 out of 17 patients, using your experience as a for-instance, in an ER aren't in life-threatening conditions.

I wish they would communicate everything as well---it makes it easier all around. And frankly, it doesn't really take that much time. Remember, 16 out of 17 was a distant assessment at single moment in time---in real life there are times that serious cases come in droves and times where it is more like a flu clinic. As Momma always said, ER life is like a box of chocolates--you never know what you get

[Bonnevie]

Thank you for the update---my info is about 10-12 years old.
The 129,000 number was just what we were told in 1978, it may have included non-US citizens, or been inflated to emphasize the competitiveness of the process, so my apologies
According to your own citation, medical school applicants dropped from 47,000 to 32,000 from 1996 to 2003--but yes, those numbers have since rebounded
It did not state whether "residency programs" also included fellowship programs. Since many fellowships went from 2 to 3 years, the number finishing each year declined by 33%. In addition, about 50% of medical school graduates are now women, and that is great---however, women physicians tend to work less hours and have career interruptions for maternity leave, numbers alone don't tell the whole story

I still question the qualifications of new applicants. MCAT scores have declined. The pass rate on NBME pat I is now down to 85%---a test that my dog could pass( yes, that's a hyperbole). I sat on the admissions committee at SUNY and we had applicants with 2.3 GPAs and 35 on the MCATs---so not all "applicants" are created equal

Now, that takes care of new physicians, and your numbers are accepted. It does not include the accelerated attrition of existing physicians. The AMA estimated that as many as 250,000 current clinical MDs out of 900,000 will be lost to alternative careers and early retirement over the next 5 years. And the demand will only go up. In addition, more physician time is spent on documentation and regulation, so the number of hours in direct patient care has declined, per physician

I love nurse practitioners, but there is a pitfall there also. NPs, on average , will order far more lab tests and imaging procedures for the same condition than an experienced MD would. This drives up cost. They do spend more time with each patient, but therefore see less numbers, so you cannot substitute them for MDs 1 for 1.

So regardless of some of my inaccurate or out of date numbers, I stand by my opinion that the quality of medical in the US is going to go down, not up.

your observations mirror mine having worked in hospitals for over 30 years and seeing the caliber of graduates decrease over that time.

I appreciate your informed insight.

[golfing eagles]

your observations mirror mine having worked in hospitals for over 30 years and seeing the caliber of graduates decrease over that time.

I appreciate your informed insight.

Thank you. Obviously you just joined me in the "BS" club:1rotfl::1rotfl::1rotfl:

It's OK, we have a lot of company---like 99% of healthcare professionals

I would repeat the misquote "Ignorance is Bliss", but the full quote is "WHERE ignorance is bliss, 'tis folly to be wise" Maybe both apply:1rotfl::1rotfl::1rotfl:

[rosygail]

My husband waited 10 hours to see a doctor in the TVRH ER on March 2nd, and he was having chest pain! This is unexcusable care! They must do better!

[goodtimesintv]

Lots of opinions and a couple of "facts" upon which those opinions were formed.
Easiest to fact check, how many applicants were there for medical schools in 1978? was is 129000 US applicants? Not even close. In 1978 there were under 30,000 applicants. The last year reported in 2014 had the highest number of applicants in history..........

When you start with non-factual facts, you might end up with non-reasonable conclusions, or not

As to what we Americans will stand for, that is for the political forum but to suggest that there is some secret conspiracy of people attempting to collapse the health care industry is ....

Speaking of "When you start with non-factual facts"......in this quote above, you have a huge non-premise premise.

Number of medical school graduates is not the problem with the looming and already present shortage of primary care physicians!

Besides the fact that many grads do not choose primary care specialties like family practice or internal medicine because these specialties do not pay enough to repay $350,000 to $400,000 of student loan debt and still afford to buy a home and normal living expense......there is THIS:

"Most people are aware of America's looming physician shortage, but the shortage of residency slots for medical school graduates has received less attention.

In order to practice medicine in this country, graduates of allopathic (MD) and osteopathic (DO) medical schools must complete a residency training program. In recent years the number of MD and DO graduates has increased by more than 23 percent in an effort by schools to address the country's growing physician shortage, which the American Association of Medical Colleges estimates will approach 90,000 too few physicians by 2025.

While the number of medical school graduates is increasing, the number of residency training positions has not kept pace. If this imbalance is not addressed, the number of American MD and DO graduates will exceed the number of first-year residency positions, which by some estimates could occur as soon as 2017.

When this happens, young physicians-who dedicated years to the pursuit of a medical education and incurred significant debt doing so-will not be able to practice medicine, and the physician shortage will persist.

Part of the problem stems from the funding mechanism for Graduate Medical Education (GME). Medicare covers the majority of the cost teaching hospitals spend on training medical residents, but the Balanced Budget Act of 1997 capped the number of residency slots the federal government would fund....."

Shortage of residency slots may have chilling effect on next generation of physicians | TheHill (http://thehill.com/blogs/congress-blog/healthcare/266610-shortage-of-residency-slots-may-have-chilling-effect-on-next)

[champion6]

My husband waited 10 hours to see a doctor in the TVRH ER on March 2nd, and he was having chest pain! This is inexcusable care! They must do better!Your description seems to imply that he had or was having a heart attack. When he was seen by a doctor, what was his diagnosis? Did he have a heart attack?

[crabbyannie1]

My mom developed double pneumonia and was sent to er from premier medical and waited 9 hours before getting room and treatment. Mom got better thank God! But, have been advised in the future to only go to the villages hospital by ambulance or it may be your last hospital stay ever! Unacceptable!

Please take my word for it...being transported there by ambulance means nothing. You still wait after triage. I waited 9 hours and my husband waited 5. The busiest hospitals in NYC don't have this kind of backlog. They really don't.