Whatever your logic or reasons are, I much prefer debating the points with an occasional barb thrown in, than the vitriolic ad hominem attacks. FWIW, I appreciate the answer. I'm not saying we can take long showers to the wee hours of the morning together or anything like that though. Just a simple thanks for a straight forward answer minus the drama.
You are truly a hopeless case CHG, but I will continue on my quest to bring you out into the light of knowledge and reason (however Quixotic that quest may be).
I also suppose that your reference to gleaning barns is implying that this to is a Christian creation and that this never occurred anywhere until it was so commanded in the Christian bible?
Have you been hitting Lunati's ether?
Jeff I hear what you're saying about the repubs blocking reform at all costs, but you can not exonerate the dems that allowed the industries that stood to loose the most to write up the drafts for this legislation. It's like hiring the fox to guard the hen house.
Man oh man! The time that would be had at the MFUCC party with this crowd!
Hey packrat, you stole my answer!
To be honest wear the funny hat, while getting drunk enough to take off your shirt while dancing in a pentagram of lit candles. That should cover it. If not, heed Jeff's first bit of advice.
Instead of getting into a pissing contest I will just say that all of the ERs in town are the same when it comes to this. You are going to have to wait. Longer at some than others, but you will wait. The state stepped in and said no more diversions, so saying "the other" hospitals are on diversion is what is creating the problem is good old fashioned blame shifting. The problem is the system we have now. Period. The ER is being used as everything from a primary care provider to a pharmacy and everything in between. No one is criticizing the staffs or the institutions, just simply pointing out the reality and gravity of the situation. All of the hospitals have expanded and are always looking for ways to improve the process. They are quite simply overwhelmed. AND every hospital takes every possible measure to get the critically ill patients in a bed and begin care as soon as possible. Stop trying to point the finger of blame when we are all in the same pool of quicksand and rapidly sinking.
Where do you want to begin???
First, the ambulances. The city routinely runs out of ambulances because of the de facto policy "you call, we haul". This has become the norm for many reasons. One, with requiring paramedics to be fire fighters also, the quality of care provided overall has dropped. People go through paramedic training simply to get hired on and then promote away from being a paramedic. (This doesn’t apply to everyone of course, but I have to include this disclaimer or else I get flamed.) Another reason is that receiving a complaint is the worst possible thing that can happen to someone on the fire department. A complaint from a private citizen about being rude or inattentive is far more trouble than hauling them to the hospital. No matter how superfluous or unfounded it may be, guilty until proven innocent. Plus if you're waiting at the hospital you'll miss a couple of calls in your territory, meaning less paperwork and chance for a complaint. With less than favorable attitude and the litigious society in which these paramedics operate, arriving and providing evaluation and basic care is out of the question. Complaints and lawsuits would follow like a tidal wave, even if they are unwarranted, and the city just doesn’t want to deal with the hassle.
This applies to private, for profit providers of 911 services as well. EMS should be a third service public utility with equal footing to the police and fire departments. North Carolina law addresses this.
The hospitals do try hard, but when there is no room, there is no room and ambulances have to wait (yes, even at Baptist). The body that regulates hospitals will not allow the ER to put patients along the hallways anymore, a practice that helped speed up the process a little bit a few years ago. The nurses are strongly discouraged from placing people directly in to the waiting area if they arrive by ambulance now, even if it is a minor complaint. The hospital legal department, due to complicated federal legislation, will not let the ER staff tell people that they need to be seen at the clinic or primary care doctor for fear of legal action. Due to lack of payments received and lower reimbursement than actual cost from government programs, staffing becomes an issue. You can’t schedule nurses to work if you can’t pay them.
The population at large is perhaps the largest factor in this equation. More people go to the ER now than ever before. This cuts across all socio-economic lines. Every major hospital ER in Memphis has undergone a major expansion in the past few years, and they are still overcrowded. The people on the lower rungs of the economic ladder go there for primary, urgent, and emergent care. Higher up the ladder, people will go to the ER simply because they have insurance and don’t want to wait to see their own doctor. Then you have the group that if they are so much as bumped by a shopping cart they feel the need to go to the ER so they might sue someone. People go to their doctor or one ER, are evaluated, treated, and given medication, then the very next day are going to the ER because they do not feel better yet. Some don't even wait an entire twenty four hours.
This is just the tip of the iceberg. This is where true health care reform needs to start, not throwing money at some government insurance scam. Move full control of EMS to the Health Department (the only reason the fire department has held on to it is to justify their budget, as EMS calls constantly go up every year, and fire calls go down). Put mobile health clinics out in the neighborhoods over-utilizing the 911 system the most. This will help educate the public. Let paramedics be paramedics (the full fledged medical professionals that went to school to be) provide primary health screenings, primary care, and urgent care, then release the patients without transporting (this is done in the UK with great success). Have the entire system guided by a consortium from all of the major hospitals and the Health Department. This way the system can be fluid and adaptable, instead of static and reactionary. Hospital administrators, doctors, and legislators need to work together for some sort of tort reform and ways to decrease government interference without short changing the care given.
There are a lot of really good paramedics, nurses, and doctors out there. Let’s give them the tools to help them do their jobs to the best of their abilities for the betterment of our community.
All Comments »
By Louis Goggans
download this issue
click here to see more »