A Litany Of ER Abuses
In a recent column, I discussed the forthcoming closure of the Cook Medical Center ER and why it shouldn’t be happening. Unexpectedly, at least to me, that column appears to have gone “viral.” Of the tens of thousands of people reached, surprisingly, I received only three negative responses – all of which I found rather amusing. One person referred to me as “anti-Christian” (really?). Another stated that “grouping people into groups” was wrong (self-explanatory). And, yet, a third explained how aghast she became when she discovered that her primary care physician required payment for service (the nerve!).
In spite of the negative tone, these comments offered something beyond mere entertainment value – that is, proof that with regard to the dire circumstances facing Georgia’s and America’s ERs, some people just don’t get it. So, in response to these misinformed types, I gladly offer a few examples for purposes of enlightenment. If you are a taxpayer, prepare to be angry.
I once had a patient present to the ER complaining of “stiff hair” (I’m not making this up). It turns out, she had placed a straightener on her hair and, later that night, around 1:00AM, showed up asking if we had something that would remove the straightener – and all at taxpayer expense.
“Baby’s first picture” is a common scam. It works this way – young pregnant females wait until around 20 weeks gestation. Then, they call 911 complaining of pelvic pain and leaking fluid (which, of course, is a fabrication). This gets them a free ride to the ER and a complete work-up including trans-abdominal ultrasound during which the ultrasonographer captures images of the developing fetus for the medical record. The patient then asks for copies of these images which she later displays to her friends and family as “baby’s first picture” – and all at taxpayer expense.
For many years, the most shoplifted items in America were home pregnancy tests, that is, until these shoplifters discovered they could acquire them for free at ERs. So, nowadays, the scenario goes like this…Patient: “I’m eight weeks pregnant and I need a pregnancy test.” Triage nurse: “Have you been to your doctor for an exam?” Patient: “No, I need a pregnancy test first so I can get my Medicaid started.” Nurse: “Have you taken a home pregnancy test?” Patient: “No, I don’t have the money,” after which she gets a free pregnancy test – and all at taxpayer expense.
Opiate addicts frequent ERs complaining of various pain syndromes in attempts to acquire prescriptions for narcotics. A common scam follows: an addict presents complaining of flank pain from kidney stones because he knows the treatment often includes narcotics. The doctor orders a urinalysis to evaluate for the presence of blood in the urine – no blood often means no kidney stones which often means no narcotic prescription. Of course, the addict knows this and comes prepared – he has acquired a lancet from a diabetic relative or friend and, when he goes into the bathroom to provide a urine sample, he pricks his finger with the lancet, sticks his finger into the sample and, voila, blood in the urine which likely means a prescription for narcotics – and all at taxpayer expense.
For additional perspective, consider an all too common scenario: A patient with a history of high blood pressure and diabetes calls 911 at 2:00AM complaining of right knee pain. He gives these answers to the following questions: How long has your knee been hurting? “Three months.” What have you taken for pain? “Nothing.” Did you injure your knee at work? “I don’t work.” Have you seen your doctor about your knee pain? “I ain’t got no doctor.” Who writes your prescriptions for your blood pressure and diabetes medication? “I go to the ER.” How will you get home when we are finished? “My family, they’re in the lobby” (having followed the ambulance to the hospital). So he gets an x-ray, is diagnosed with mild osteoarthritis (which, of course, isn’t an emergency and doesn’t justify ambulance transport), receives an injection for pain and a prescription, and goes on his way – and all at taxpayer expense.
Ah, and the ER scams go on and on and on…the person who calls 911 complaining of chest pain in order to get a ride to town; the alcoholic who drank his enter Social Security check and comes to the ER to get medication to manage his withdrawal symptoms; the weekend partier who presents on Sunday night seeking a work excuse in anticipation of a Monday morning hangover; members of the Friday Night Gun and Knife Club who shoot and stab each other over real or perceived slights and then get dropped off by friends in the ER parking lot or ambulance bay; the Sunday lunch crowd who, amazingly, never seem to get sick during church services but somehow manage to become acutely ill at the conclusion of the sermon; and the people who visit the ER instead of their doctor because their doctor charges a co-pay or they just don’t have time to make an appointment or they just don’t like waiting in the doctor’s office or whatever, whatever, whatever – and all at taxpayer expense.