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Arthur T Knackerbracket has found the following story:
SAN FRANCISCO — When John Battelle's teenage son broke his leg at a suburban soccer game, naturally the first call his parents made was to 911. The second was to Dr. Jordan Shlain, the concierge doctor here who treats Mr. Battelle and his family. "They're taking him to a local hospital," Mr. Battelle's wife, Michelle, told Dr. Shlain as the boy rode in an ambulance to a nearby emergency room in Marin County. "No, they're not," Dr. Shlain instructed them. "You don't want that leg set by an E.R. doc at a local medical center. You want it set by the head of orthopedics at a hospital in the city." Within minutes, the ambulance was on the Golden Gate Bridge, bound for California Pacific Medical Center, one of San Francisco's top hospitals. Dr. Shlain was there to meet them when they arrived, and the boy was seen almost immediately by an orthopedist with decades of experience.
For Mr. Battelle, a veteran media entrepreneur, the experience convinced him that the annual fee he pays to have Dr. Shlain on call is worth it, despite his guilt over what he admits is very special treatment. "I feel badly that I have the means to jump the line," he said. "But when you have kids, you jump the line. You just do. If you have the money, would you not spend it for that?"
Increasingly, it is a question being asked in hospitals and doctor's offices, especially in wealthier enclaves in places like Los Angeles, Seattle, San Francisco and New York. And just as a virtual velvet rope has risen between the wealthiest Americans and everyone else on airplanes, cruise ships and amusement parks, widening inequality is also transforming how health care is delivered. Money has always made a big difference in the medical world: fancier rooms at hospitals, better food and access to the latest treatments and technology. Concierge practices, where patients pay several thousand dollars a year so they can quickly reach their primary care doctor, with guaranteed same-day appointments, have been around for decades.
But these aren't the concierge doctors you've heard about — and that's intentional.
Dr. Shlain's Private Medical group does not advertise and has virtually no presence on the web, and new patients come strictly by word of mouth. But with annual fees that range from $40,000 to $80,000 (more than 10 times what conventional concierge practices charge), the suite of services goes far beyond 24-hour access or a Nespresso machine in the waiting room.
Indeed, as many Americans struggle to pay for health care — or even, with the future of the Affordable Care Act in question on Capitol Hill, face a loss of coverage — this corner of what some doctors call the medical-industrial complex is booming: boutique doctors and high-end hospital wards.
-- submitted from IRC
(Score: 5, Informative) by Thexalon on Monday June 05 2017, @05:43PM (10 children)
That's total nonsense. My sister is an ER doctor, and has done just about all the jobs you can do in emergency medicine starting from driving the ambulance, and one reason she focused on ER is that it's actually the place where she can save the most lives. ER doctors focus on procedures where time is a critical factor, dealing with injuries, and also are the best in the business at triage. Generally, once you're an ER doc, you stay an ER doc throughout your career: The salaries are a bit lower than other specialties, but the big perk is that you show up at work, do your shift, solve some problems, and go home and don't have to worry about being on call or long-term care or any of that.
If you go into the ER for a broken wrist, don't expect prompt service, because the first thing the ER is going to do is take one look at you and see you aren't likely to die while you wait. If you go into the ER from an ambulance when you just had a bunch of bones broken and are bleeding profusely, you bet your butt you're going to be taken care of, quickly. Since most visits to an ER fall into the category of relatively minor problems, that's why you get the experience of the unresponsive ER.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by VLM on Monday June 05 2017, @05:57PM (6 children)
I wonder how urgent care fits into this. I've gone there a couple times. There's generally no line and they don't seem flooded with illegals which makes me think urgent care isn't covered for illegals.
But I've been there for some pretty messed up stuff requiring xrays and hospitalization (not me, MiL, everything turned out fine)
I've heard if you're really Fed up and show up at urgent care they'll kick you out to an ER. I don't know if that's procedure or "just that one time". I have a coworker who had a heart attack get kicked out of urgent care... then again they didn't make him wait with the illegals in the ER when the ambulance rolled him into triage.
The way the flowcharts work AFAIK from observation:
"Not acutely sick but you have some kind of (preventative?) need" you make a primary care appointment in 3 weeks and get a referral or maybe not in 3 to 7 months to a specialist. They work a little faster for pregnancies, a little slower for stuff like "sports medicine"
"Sick but not gonna die today and have insurance" goto urgent care they'll either patch you up or kick you out to ER, usually not much waiting.
"Sick gonna die real soon, might make it if treated, and have insurance" goto ER triage room no waiting room
"Don't have insurance, just looking for a place to sleep or free pain pills or free meal" goto ER waiting room for 10-15 hours
(Score: 2) by sjames on Monday June 05 2017, @06:15PM (4 children)
It may not be this way everywhere, but where I am, urgent care can't actually seem to DO anything but tell you to go to the ER. I took my wife to one and they said she looked a bit dehydrated, so since they can't give an IV, we needed to go to the ER.
Of course, if you don't seem to be trying to die, most ERs are best called eventual care. If it's after 3 or 4 on Sunday, you'll probably be seen sooner by getting a GP to squeeze you in for an office visit on Monday.
(Score: 2) by VLM on Monday June 05 2017, @06:33PM (1 child)
I bet that's regulated at state level, much like physicians assistants.
One interesting problem with "federalizing" medical care is its already been done with old and disabled people but the regulation is still at state level so it must be hilarious fun trying to impose federal care standards on 50 states.
That might be an interesting strategy for fixing the medical system, start with the supply side and standardize the docs and licensing completely first.
Its not like the feds don't know how to license things. I have FCC licenses which were tested and approved at the local level and only issued by the feds, maybe they could license doctors that way, at least to start.
(Score: 2) by sjames on Monday June 05 2017, @06:48PM
It may just be crappy urgent care. I recieved an IV from the oral surgeon when I had my wisdom teeth out. Paramedics can give you an IV at the side of the road. When the Nats visit here, Strasburg gets an IV in the clubhouse before the game so he doesn't get heat stroke later.
So much for going to urgent care to relieve the strain on the ER.
(Score: 2) by Thexalon on Monday June 05 2017, @08:52PM (1 child)
Which, if it's the kind of problem your GP can handle, is exactly what you should be doing. The emergency room is intended to be where you go for, you guessed it, emergencies. The kinds of things that will get significantly worse if you wait for too long.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by sjames on Monday June 05 2017, @10:08PM
Some non life threatening conditions cause blackout level pain. It would be nice if there was somewhere you could go that would help people manage that in under 12 hours. Urgent care won't touch that with a 10 foot pole and you can't get anything over the counter that will even make a difference.
Oddly, if it's tooth pain, you can probably get the dentist to call something in on Sunday night if you promise to come see him during office hours.
(Score: 2) by Sulla on Monday June 05 2017, @07:39PM
At my location if you call an ambulance you get kicked to the front of the line. So if your insurance covers it or have a small copay (mine is $100) it might be worth doing that. Personally I think its wrong to use that loophole for anything not actually serious so have never tried.
Ceterum censeo Sinae esse delendam
(Score: 2) by JoeMerchant on Monday June 05 2017, @08:37PM
It all depends... some ER docs are great, some are too f-ing tired and careless to bother cleaning broken glass out of a wound before they stitch it up.
🌻🌻 [google.com]
(Score: 2) by MichaelDavidCrawford on Monday June 05 2017, @09:39PM (1 child)
If I think I need to check in to a psychiatric inpatient unit, I go to the emergency room. If they agree they'll set me up with such a unit. Sometimes I go for a ride in a special kind of limousine, from which escape is impossible.
Yes I Have No Bananas. [gofundme.com]
(Score: 2) by c0lo on Tuesday June 06 2017, @01:18PM
Lemme guess... they have hookers to keep you down.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford