[Vernster]

Originally Posted by ilovetv

You purposely miss the point in order to ridicule.

The insurance, Medicare and Medicaid paperwork, documenting to CYA in case of malpractice lawsuits, and now electronic medical records are making the drs. spend their time on everything but patient care. This is part of the problem at TVRH and every E.R.:

"Robert G. Hill Jr, MD, from St. Luke's University Health Network, Allentown, Pennsylvania and colleagues analyzed time use in their emergency department and found that physicians spent 43% of their time, on average, performing data entry, or roughly twice as much as that spent on direct patient care. Their study was published online September 23 in the American Journal of Emergency Medicine.


During a busy 10-hour shift, their calculations suggested that a physician might perform a finger-numbing 4000 mouse clicks entering data.

"Emergency department physicians spend significantly more time entering data into electronic medical records than on any other activity, including direct patient care," the investigators note. "Factors such as operating system speed, server/mainframe responsiveness, typing skills, user-friendliness of system, interruptions, extent of training, opportunity to delegate tasks, and various environmental attributes can influence data entry time. Efficient use of the EMR system will increase physician productivity and hospital revenue," they maintain.

Although EMRs are now the federally mandated standard for medical records, they are still controversial, with hefty up-front costs and uncertain benefits, according to the investigators......"

http://www.medscape.com/viewarticle/811841

THANK YOU Ilovetv
I don't like to be ridiculed. Your entry is entirely correct and well stated. Thank you.

[buggyone]

Originally Posted by Vernster

THANK YOU Ilovetv
I don't like to be ridiculed. Your entry is entirely correct and well stated. Thank you.

Vernsters post had to do with doctors having a great deal of school debt when beginning a practice and therefore most had to join a large firm. He also said that doctors could no longer set up their own office and charge patients whatever they wanted.

[kja966]

As an urgent care physician in Wisconsin I am not surprised by the overcrowding in the ER. Building new facilities would make sense except medicare is being slashed, hospitals are moving to extreme cost savings mode, and frequently the ER is used inappropriately for common problems. Everyone coming in is triaged and the serious illness goes first and less serious are left for later. Having an urgent care center open later may make some sense if financially viable but that raises a whole new set of problems. People with serious illnesses start showing up at urgent care (usually to save ER costs) and end up being referred on to the ER, sometimes in an ambulance, because their problem cannot be handled at that level. That just leaves patients frustrated. I personally would rather pay directly for a convenient clinic to be seen rather than play the insurance game to save $50 and wait hours. Most stand alone urgent cares bill clinic office rates while anything attached to or part of a hospital is at ER rates. That can mean $200 vs $2000 for something like bronchitis. Florida is also known as a malpractice nightmare state.

[ilovetv]

New York Times:

Emergency Rooms Are No Place For The Elderly

"......The number of older people seeking health care is expected to increase significantly over the next 40 years, doubling in the case of those older than 65, potentially tripling among those over 85.

In a health care system already critically short of primary care providers and geriatrics specialists, many of these older patients will likely end up in emergency rooms.

But given longstanding trends in American medicine, it’s hard to imagine a health care setting more ill suited for the elderly than today’s emergency rooms.

Over the last five decades, quality emergency care has become synonymous with speed. Survival rates for patients in the throes of a stroke, heart attack or traumatic injury depend on the number of minutes needed to triage, diagnose and treat. Even the physical environment where emergency care takes place has become a paragon of medical efficiency — large echoing spaces that can be divided at a moment’s notice with panels of curtains, slick linoleum floors that can be mopped up in minutes and bright fluorescent lights.

More recently, as overcrowding has become a significant problem, the drive for efficiency has become more pronounced, with doctors and nurses having to work as quickly as possible simply to see all the patients.

But when it comes to elderly patients, it is nearly impossible to work quickly. Many are plagued by multiple chronic diseases like diabetes, high blood pressure and heart disease, take numerous prescription drugs that can cross-react in potentially dangerous ways and suffer from ills like dementia that can make the answer to even the simplest of questions – What brought you to the emergency room today? – difficult to understand......

See Full Story:

http://well.blogs.nytimes.com/2014/0...ef=health&_r=1

[Carl in Tampa]

Originally Posted by gatherer47

I'll stand by my original statement-an eleven hour wait for a sick child is totally unacceptable

Of course it is. You were a 90 minute drive from Tampa, which has many 24 hour urgent care facilities as well as three major Hospital Systems (Tampa General, St. Joseph's and Florida Hospital) which each has multiple locations. Your chances of being seen sooner might have been improved in Tampa. Some phone calls may have paved the way.

However, it has been my experience that all three hospital ERs become swamped at night, worse on weekends, by indigent patients.

My most recent experience at TVRH, arriving at 6PM with a friend awaiting admission, was sitting in the ER waiting room for three hours to see the Triage Nurse and not getting back to a treatment room until around 2AM, and then the friend was admitted the next morning when a current patient checked out. And this was with a referral from a doctor at Urgent Care for admission.

The ER problem at TVRH is bad, but it is characteristic of similar problems elsewhere and does not qualify as "a black eye" on TV.

[sr1436]

Go straight to Leesburg or Ocala. TV hospital sucks.

[buckscounty]

The villages emergency is the worst and i hear the hospital isn't any better.

[GrandmaP]

Can't address the pediatric issue but my husband was sent to ADMITTING with a diagnosis of acute appendicitis ( he had blood tests and CT scan results in hand and a call from the physician's office was made) He was put in the ER waiting room and after a 4 hour wait, his appredix ruptured.

[CFrance]

Originally Posted by GrandmaP

Can't address the pediatric issue but my husband was sent to ADMITTING with a diagnosis of acute appendicitis ( he had blood tests and CT scan results in hand and a call from the physician's office was made) He was put in the ER waiting room and after a 4 hour wait, his appredix ruptured.

That is horrendous. I hope he is okay.

[ilovetv]

Originally Posted by GrandmaP

Can't address the pediatric issue but my husband was sent to ADMITTING with a diagnosis of acute appendicitis ( he had blood tests and CT scan results in hand and a call from the physician's office was made) He was put in the ER waiting room and after a 4 hour wait, his appredix ruptured.

And now. What caring and competent primary physician wants to send another of their patients to that ER, knowing another patient can likely experience that or WORSE??

Seems like everyone ought to be looking at whether their doctor can refer them to another hospital and ER, or if they can ONLY refer to this one!!

And who's going to clean house on this hospital's administration that forms/maintains a set-up like this, that exposes patients to unnecessary dangers, and exposes the hospital and ER doctors and nurses to huge malpractice possibilities?

Administration isn't going to fire themselves. I think the Morse Family needs to get involved and make heads roll. They would never keep sloppiness like this in management of their TV enterprises that get things DONE, and done right!