[kdmerida]

You were very lucky as that is rare. They usually are short of nurses and doctors on call.

[graciegirl]

Originally Posted by kdmerida

You were very lucky as that is rare. They usually are short of nurses and doctors on call.

Not sure what post you are responding to and what nurses and doctors .....

[dbussone]

Originally Posted by dillywho

I can tell you why. Their health is not a priority for them, so they don't have insurance or doctors. They prefer to spend their money on wants rather than needs. They depend on the ER's for their care. Hospital ER's have to treat, regardless of the ability to pay; Urgent Care facilities do not. The Villages Hospital has an Urgent Care facility. I asked one time why non-emergency cannot be sent over there. That's when they told me that they have to take them, but Urgent Care does not.

Under the federal law called EMTALA, ERs must take and treat emergent patients. Non-emergent patients can be discharged, without treatment, from the ER, after a brief screening exam.

Whomever told you ERs have to treat everyone doesn’t know what they are talking about. It is true that ERs must treat without regard to payment, but again, only for emergent patients.

If The Villages hospital wanted to they could have a nurse (or PA, or ARNP) conduct a preliminary screening exam and triage a patient to a more appropriate setting. If the nurse were unsure, he/she could refer the patient for a screening exam by a physician.

With an overflowing waiting room, a screening exam would be useful in eliminating patients who did not need the level of care provided in an ER. In one of my hospitals we placed a nurse in the waiting room. It was that person’s job to perform a screening exam within five minutes of arrival. That exam eliminated all the drug seekers, minor injuries and other lesser issues than could be referred to urgent care or even a clinic.

The Villages hospital spent millions on an expansion of the ER several years ago. I predicted then that physical enhancement was not going to resolve the problems being experienced at that time. Sorry to say I have been proven correct. The bottlenecks are primarily people and processes - not folks in beds upstairs waiting to be discharged.


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[golfing eagles]

Originally Posted by dbussone

Under the federal law called EMTALA, ERs must take and treat emergent patients. Non-emergent patients can be discharged, without treatment, from the ER, after a brief screening exam.

Whomever told you ERs have to treat everyone doesn’t know what they are talking about. It is true that ERs must treat without regard to payment, but again, only for emergent patients.

If The Villages hospital wanted to they could have a nurse (or PA, or ARNP) conduct a preliminary screening exam and triage a patient to a more appropriate setting. If the nurse were unsure, he/she could refer the patient for a screening exam by a physician.

With an overflowing waiting room, a screening exam would be useful in eliminating patients who did not need the level of care provided in an ER. In one of my hospitals we placed a nurse in the waiting room. It was that person’s job to perform a screening exam within five minutes of arrival. That exam eliminated all the drug seekers, minor injuries and other lesser issues than could be referred to urgent care or even a clinic.

The Villages hospital spent millions on an expansion of the ER several years ago. I predicted then that physical enhancement was not going to resolve the problems being experienced at that time. Sorry to say I have been proven correct. The bottlenecks are primarily people and processes - not folks in beds upstairs waiting to be discharged.


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Agree 110%. Right on target as usual.

[dbussone]

Originally Posted by golfing eagles

Agree 110%. Right on target as usual.

Wow. That was quick! [emoji41][emoji106]


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[JanBrown]

Originally Posted by aletarw

I am considering moving to the Villages. Hospital crowding concerns me. Is this normal for hospitals in the Villages?

During snowbird season, yes this is normal. Plus when a hospital in the area starts turning patients away (due to no rooms available), other hospitals take the brunt and then THEY have to start turning patients away.

But the question I have is...WHY IS EVERYONE WITH THE FLU GOING TO THE HOSPITAL instead of staying home until it moves out of your body. Or if you feel you really HAVE to see a doctor, why not go to an Urgent Care facility???

Originally Posted by dbussone

Under the federal law called EMTALA, ERs must take and treat emergent patients. Non-emergent patients can be discharged, without treatment, from the ER, after a brief screening exam.

Whomever told you ERs have to treat everyone doesn’t know what they are talking about. It is true that ERs must treat without regard to payment, but again, only for emergent patients.

If The Villages hospital wanted to they could have a nurse (or PA, or ARNP) conduct a preliminary screening exam and triage a patient to a more appropriate setting. If the nurse were unsure, he/she could refer the patient for a screening exam by a physician.

With an overflowing waiting room, a screening exam would be useful in eliminating patients who did not need the level of care provided in an ER. In one of my hospitals we placed a nurse in the waiting room. It was that person’s job to perform a screening exam within five minutes of arrival. That exam eliminated all the drug seekers, minor injuries and other lesser issues than could be referred to urgent care or even a clinic.

The Villages hospital spent millions on an expansion of the ER several years ago. I predicted then that physical enhancement was not going to resolve the problems being experienced at that time. Sorry to say I have been proven correct. The bottlenecks are primarily people and processes - not folks in beds upstairs waiting to be discharged.


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This makes sense to me. At least someone willing to admit there is a problem that can be improved with a some planning and policy changes. That was the only point that I was trying to make.

[dbussone]

Originally Posted by fw102807

This makes sense to me. At least someone willing to admit there is a problem that can be improved with a some planning and policy changes. That was the only point that I was trying to make.

I’m pleased you think my response was logical. I spent the better part of my career trying to make sure those who reported to me did their best to improve hospital operations. I made it a point to Implement best practices in all the hospitals that reported to me.

I should also note that Golfing Eagles, MD, has a tremendous background in ERs and physician practices. He and I may make some statements that some don’t like, but we do our best to be honest and constructive.


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Originally Posted by dbussone

I’m pleased you think my response was logical. I spent the better part of my career trying to make sure those who reported to me did their best to improve hospital operations. I made it a point to Implement best practices in all the hospitals that reported to me.

I should also note that Golfing Eagles, MD, has a tremendous background in ERs and physician practices. He and I may make some statements that some don’t like, but we do our best to be honest and constructive.


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I just get annoyed when people throw up their hands and say there is nothing that can be done when I know there is, I don't know what but I know there has to be a better way.

[jnieman]

Originally Posted by Abby10

Posting these together because this is definitely part of the problem. It is beyond me why people do not use urgent care more often. When I had the flu last year, instead of calling my doctor to get an appt, I immediately went to the local urgent care. They took me right in, tested me, gave me medication, and I was home and in bed in no time. The doctor's visit would have been cheaper but I knew, besides the antiviral med, what I really needed was fluids and bedrest, so I wanted to make the visit as quick as possible. No phone call needed, just go there.

The ER is often overused and downright abused by some. The last time I took my husband to the ER for a kidney stone, the young man in the next bed had come in because he had just gotten his medical assistance card and wanted to have "a few things checked". "Things" that he had been letting go for months that were definitely not urgent but I guess he thought it would be easier to go to an ER than to find a primary care doctor. I have seen this with a lot of younger people, especially those on assistance. They abuse the ER instead of taking the time to find a PCP.

Note: Before I get slammed by someone for the comment, let me say, I use those on assistance as the example only because most who get insurance through work or on their own usually have high co-pays ($300-600) for ER visits and wouldn't think to go there unless they absolutely had to.

I went to the urgent care and there were 16 patients ahead of me most coughing and hacking. It felt actually dangerous to be in that room with all of those germs. I left there, called my doctor got an appt for the next morning. Went to his empty office the next day and was seen in 20 minutes. I much prefer this and will only go to the urgent care if I have no other choice. I think this time of the year there are two reasons for the urgent cares to be slammed. One is the fact that there are so many renters here who have no primary care doctor to call. Second of course is that we have so many cases of the flu right now going around.

[golfing eagles]

Originally Posted by JanBrown

During snowbird season, yes this is normal. Plus when a hospital in the area starts turning patients away (due to no rooms available), other hospitals take the brunt and then THEY have to start turning patients away.

But the question I have is...WHY IS EVERYONE WITH THE FLU GOING TO THE HOSPITAL instead of staying home until it moves out of your body. Or if you feel you really HAVE to see a doctor, why not go to an Urgent Care facility???

Simple answer-----FEAR

Not so simple solution------According to the CDC, the highest year for adult flu vaccination in the last decade was 2009-10, with only 43.6% getting their flu shot. Want to SIGNIFICANTLY lower your chance of getting the flu? Want to avoid the crowded ER? Want to save the cost of doctor, ER visits and expensive antiviral meds? GET YOUR FLU SHOT, EVERY YEAR!. No, it is not 100% effective, but it is still your best chance to avoid the flu.

[Abby10]

Originally Posted by jnieman

I went to the urgent care and there were 16 patients ahead of me most coughing and hacking. It felt actually dangerous to be in that room with all of those germs. I left there, called my doctor got an appt for the next morning. Went to his empty office the next day and was seen in 20 minutes. I much prefer this and will only go to the urgent care if I have no other choice. I think this time of the year there are two reasons for the urgent cares to be slammed. One is the fact that there are so many renters here who have no primary care doctor to call. Second of course is that we have so many cases of the flu right now going around.

Sounds like you made a wise move to call your doctor and avoid the germs. When I had the flu, my doctor's office was overloaded, but at the urgent care I walked in and was the only patient there. I'm still up north so it may be a little different up here with the situation being reversed. Either way, it seemed to work out the best for both of us. Hope you are finally feeling better, by the way.

[Abby10]

Originally Posted by dbussone

Under the federal law called EMTALA, ERs must take and treat emergent patients. Non-emergent patients can be discharged, without treatment, from the ER, after a brief screening exam.

Whomever told you ERs have to treat everyone doesn’t know what they are talking about. It is true that ERs must treat without regard to payment, but again, only for emergent patients.

If The Villages hospital wanted to they could have a nurse (or PA, or ARNP) conduct a preliminary screening exam and triage a patient to a more appropriate setting. If the nurse were unsure, he/she could refer the patient for a screening exam by a physician.

With an overflowing waiting room, a screening exam would be useful in eliminating patients who did not need the level of care provided in an ER. In one of my hospitals we placed a nurse in the waiting room. It was that person’s job to perform a screening exam within five minutes of arrival. That exam eliminated all the drug seekers, minor injuries and other lesser issues than could be referred to urgent care or even a clinic.

The Villages hospital spent millions on an expansion of the ER several years ago. I predicted then that physical enhancement was not going to resolve the problems being experienced at that time. Sorry to say I have been proven correct. The bottlenecks are primarily people and processes - not folks in beds upstairs waiting to be discharged.


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What a great idea! I knew you were a very smart man. Better watch out, The Villages hospital will be calling both you and GE and giving you offers you can't refuse to come out of retirement.

[JMB]

Monroe is now run by Shands ......Best bet is to drive up to Ocala for care.

[dbussone]

Originally Posted by JMB

Monroe is now run by Shands ......Best bet is to drive up to Ocala for care.

Shands would not be my automatic first choice for true emergency care. It would depend on the specific issue.


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