Canada Values Health - Dialogue on Health Care -

Should non-emergency users of emergency rooms be penalized?

2009-03-13 13:58:04

This topic was suggested by a Canadavalueshealth.ca visitor.

Emergency room wait times.
Is each case a real emergency ? Fevers and Colds do not constitute an emergency. The wait times for those who need it most are extended by nuisance cases. Perhaps we should charge those who are there needlessly as we do for ambulances and false alarms.

Your responses
where else can people go? ange Posted: 2009-11-11 14:47:51 I don't think it's a question of whether non-emergency users of emergency rooms be penalized or not. Rather, I think it's a matter of providing enough resources to people to turn to when they are scared and anxious about their own health and those of their loved ones. Most walk-in clinics close in the evening so there is no other choice for people who may or may not need care, to turn to.
Should non-emergency users of emergency rooms be penalized? 2009-03-13 13:58:04 Alice Posted: 2009-06-10 14:13:24 One other comment. I agree with one caller's statement about how would patients know if it was an emergency or not, and can especially understand the concerns with regard to heart attacks. It might deter a lot of people from coming in for that when they should. But on one occasion when I had a badly broken ankle (still broken today after a year) I waited in an after hours clinic for five hours for an x-ray when I couldn't walk without holding on to the walls and taking about 5 seconds for each step. In the meantime several people were x-rayed before me, including one young person who was happily jumping around. Her mother brought her in because she thought she might have broken a bone a week before. In fact, every single person who was x-rayed before I was was capable of walking quite well. I think they need to assess people seeking care a little better, especially when the one with the most severe injury is a senior and their injury is very obviously more severe than the others before them. Getting back to that wound that the doctor started on, again I think that was simply a matter of very poor assessment by the emergency nurse, especially when I had a note from the doctor asking if I could be treated before the freezing came out and was bleeding though a thick bandage. Sometimes first come, first served just doesn't make sense.
Should non-emergency users of emergency rooms be penalized? Alice Posted: 2009-06-10 14:06:24 I agree that there seems to be far too many people using the emergency system but then again, just because people feel violently ill doesn't mean they will kick and scream, so maybe I shouldn't be judging. But I also think the emergency systems are run badly. In once case, for instance, a doctor started operating on me in his office and ran into problems so I had to go to the emergency room. He gave me a letter to give to them so I wouldn't have to put up with so many needles to freeze the area again, as the needles themselves were the most painful part. But when I got there the nurse said I would have to wait in line like everybody else, so I waited for a couple of hours with my wound bleeding through the bandages while people who were laughing and telling jokes got treated first. Then I had to get all of those extremely, extremely painful shots again (six both times) because of course by then the freezing was out. They wouldn't even give me an aspirin to numb the pain of the shots until 2 minutes before when it was highly unlikely to work, because they had to wait for special authorization from somebody important.
How I know if its an emergency or not? rainyrose Posted: 2009-05-28 15:14:38 It is absurd to penalize anyone seeking care. Hospital is a place of compassion not a court of law and not certainly a police HQ or a military barrack. Consider this scenario: A 47 year old lady watching TV at her home one night suddenly develops a strange but very mild kind of bellyache (after having a briyani), moderate shortness of breath that went away with rest and a feeling of anxiety that does not go away. What do you think it is? (assuming you are not a doctor) Should she risk calling for an ambulance and RISK being PENALIZED in a court of law? Should she become more anxious for fear of being penalized? Ans. Myocardial Infarction (heart attack)
Not enough facilities harrise Posted: 2009-04-11 08:16:50 How can we penalize ER users if there is no place else to go. We need more 24 hour walk in clinics and urgent care centres so that patients who come into ER with non emergency problems can be directed to those facilities. Who would determine what is an emergency and what isn't? We can't have health care personnel playing God.
Non-Emergency Users of Emergency rooms Judy Posted: 2009-04-01 23:06:10 This is a difficult question to answer since I've been in the situation where I've been in extreme pain when I have entered the ER and by the time I have seen a doctor (usually 8 hours later) the pain has subsided to a level I could tolerate. On one hand I agree that if someone has a mild cold and they go to ER, to me that is an abuse. However that is very subjective. What if that person quite often ends up with pneumonia and is trying to be proactive (and again doesn't have a family doctor). That person knows his/her body. I would hate to have that person pay a fee because a nurse feels that person was abusing the system when in fact in the long run, he/she could are reducing the expenses of medical treatment by being proactive. Judy
ER Charges bmw Posted: 2009-03-29 10:51:57 This is a very personal subject to me. I have a heart condition, it was due to the ER that I am still around today to write this. It took me serveral trips to the ER before they discovered I had a blocked artery and was sent for by-pass. It was because two doctors saw me two nights in a row after I had been to the ER a number of times over a short period. So would the prevous trips have been charged for? If so how many lives will be lost because patients are afraid to go to the ER due to the cost ?
Leaving Emerg ABW Posted: 2009-03-24 18:42:55 I'm not sure what EH means by "A triage system is necessary to ensure, so far as possible, that an individual is not given the option of leaving....". We have a family doctor, very fortunately, and only use emerg once in a awhile - usually once annually for my daughter's asthma when it flares up and we just can't get it under control. At our last visit, three hours into our waiting period, the meds we had administered FINALLY took hold and her breathing was sufficiently normal for me to sign us out and go home without having accessed services. There was quite a protocol to signing out and I was grilled for removing her from the queue, but there was no point in using services that we did not need, so I was actually glad to remove us and help open the bottleneck for some other poor person needing assistance at 4 a.m., and there were plenty of people around. So we entered emerg in distress, and we exercised the option to leave because it made sense. I signed out with a triage nurse, as was my right. Â I would not consider us a nuisance. We were people whose circumstances changed and who opted to act accordingly.Â
Emergency Room Charges EH Posted: 2009-03-16 15:55:22 Non-emergency emergency room users should be charged a fee providing there are other alternatives within the locale; i.e. physician offices and walk-in clinics. A triage system is necessary to ensure, so far as possible, that an individual is not given the option of leaving or paying when they are really eligible for emergency care. The question is simply value for public monies.
Two problems with that bneuwelt Posted: 2009-03-14 04:31:57 Despite our "equal" health system, access to primary care is not equal. Many people with complex health problems (e.g. people with addictions, people with mental health problems) have difficulty getting a family doctor. Many use walk-ins but that's not always possible either. People have to get health care somewhere. Do we want to encourage them to wait till it's an emergency? Secondly, family docs are telling people to go to emerg when they don't have appointments available. ER overusage is a complicated issue and individuals are not always at fault for using them for non-emergency situations.
walk in clinics lpmoyer Posted: 2009-03-13 18:47:33 There must be a reason why we have so many walk in clinics, maybe it is for these people and they just don't know it.
My experience mariellb Posted: 2009-03-13 14:22:32 Personally I have gone to emergency several times for non-emergent causes, though they were causes requiring medical attention. I do not have a family doctor, and have been trying for over a year to find someone who is accepting patients to no luck. If I had a family doctor, this would be who I would have seen first for the problems. I also do not trust medicentres to have quality physicians. The number of times I have been in there to have someone simply write a prescription without a real diagnosis and for poor choices of medications is outstanding(as a pharmacy student, we learn not only about meds but the diagnostic criteria to warrant use of those meds, and I have seen better doctors prescribe this way). I did not trust a medicentre to provide me with a quality physician when I was having neurological problems, so I instead went to the University Emergency who refered me to an excellent neuro clinic. If we don't have quality walk-in clinics, where else are we to go?