The Rampant Abuse in Medicine Today: My Three Pet Peeves

May 7, 2009

Recently I was talking to an ER practitioner from another country and we were comparing notes. I have always thought that racism is most idiotic of ideas, and I always say, “people are people”. So, it came as no surprise the similarity of cases between our two otherwise different countries.

So he asked me what were some of the most annoying things we have to see in the course of the day in our ED’s. I thought I would share my thoughts on this issue by narrowing them down to three. Believe me, narrowing it down to just three was tough, but probably better for you than reading a long rant page. It also gives me the chance to allow you to comment and share some of things that annoy you – either as a fellow ER worker or from the other side as a patient. Maybe we can learn how to make the ER a better place … ok, unlikely, but at least I’m staying positive.

So here they are, my three biggest pet peeves in Emergency Medicine:

#3. Angry, Violent Drunks – Guess regular readers could have seen that one coming. I entirely fail to understand the emergency, or even the medical issue for that matter, with someone being drunk. If was a suicide attempt, that would be something, but someone who just drank too much and is now throwing up or rowdy? There is a special place in Hell for these people and their drunk friends, and I just wish there was a taxi service to that special place for which I gladly give them a voucher.

The next time you have to wait hours in the waiting room on a Friday or Saturday night (especially in a college town) while your appendix ruptures, your pneumonia is spread to others or you have another seizure – just remember, we are probably expending massive and ridiculously inappropriate resources containing a drunk that is trying to spit on us, bleed on us, bite us, punch us, verbally abuse us (children cover your ears) or otherwise treat us like a doghouse doormat.

#2. Using the Ambulance as a Taxi Service – Rescue 911 was meant for many things, and the awesome men and women of EMS are very patient and will always believe what you have to say if YOU think you are having an emergency. But there is a line, and that line is crossed way too often in the course of the day. EMS services are not limitless and if they are wasting their time with another drunk, someone who ran out of their medicines, someone with a sore throat or a cold, a child that is “crying too much” (and is amazing always quiet when they arrive to the ER), someone with hemorrhoids and the classic, “we can’t find the condom” after sex.

So once again, if you call the over stressed EMS 911 service and it takes them a while to respond to your chest pain, stroke symptoms or hemorrhaging (massive bleeding), just relax. They are probably picking up the lady who thinks there’s a condom stuck in her vagina. For any political people out there, there needs to be a solution to this issue before someone really gets hurt.

If you don’t believe there are such people out there, I offer you these video clips as evidence of the stupidity that runs rampant amongst us everyday:

And …

#1. Asking for a Prescription for Motrin or Tylenol – I really wish that President Obama could spend just one day with us in the ER before formalizing his plans for universal health-care. The current government insurance program, Medicaid, is so frequently abused that if we nationalize it, the collapse of the stock market and major banks would be a pleasant memory in comparison. This program was made available to low income and special needs families so that their children would not suffer from an inability to pay for medical care. If someone is financially treading water and they need a prescription for Tylenol, I would be so happy to write it for them. So why the fuss?

The people most commonly asking for these prescriptions usually show up to the ER with their $100 specialty manicure, cigarettes poking out of their pocket or purse and talking incessantly on their $300 cell phone. Or immigrants who for some reason are on Medicaid and want to save an extra $10 to send “back home”. Both of these specialty populations show up with febrile children who haven’t had a dose of fever medicine since their fever spiked. And it is our responsibility as tax-payers to foot the bill.

Why this annoys me so much is because there are loads of other people out there with legitimate medical needs and no way of getting assistance – Autistic kids that can’t get treatments because they’re so expensive and their parents make just enough money to not qualify for assistance, cancer patients (young and old) who cannot afford chemo for the same reason, people with outrageous medical bills that are at the brink of bankrupcy and the list goes on. Taxing Medicaid with over-the-counter prescriptions as well as inappropriate ambulance rides and ER visits (for example, to get a pregnancy test) ends up taxing the medical system so that others suffer.  There must be a way to prevent this wholesale abuse, but I for one, have not figured out how just yet.

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