Becoming the Problem: I Wasted the ER's Time, Here's What I Learned
I am wasting the time of the emergency room staff. Please stop me.
This is not the blog post I intended to write. Instead, I intended to write about the how emergency rooms should be used for LIFE THREATENING emergencies only.
I wanted to talk to you about the sniffles of children, the coughs and wheezes of heavy smokers and the ever-urgent complaint of “I need a refill” that echoes in emergency rooms across the country.
I wanted to talk about overcrowded waiting rooms and beds that are needed for people with actual -- you know – EMERGENCIES.
I was going to talk about my years working in an emergency room dealing with sore throats and triaging random rashes; about watching doctors and nurses and staff spend valuable time and energy caring for people who should be going to their primary care doctors. Or urgent care. Or the pharmacy. Anywhere but the one place designed to work with critical and emergent medical issues.
I was going to talk about this in a slightly superior tone, unavoidable from a first-year medical student, to convey the simple idea that if patients just knew better – if they just stopped and thought about their actions -- they would stop contributing to the congestion and shortages that plague most emergency room settings.
Believe me, I had a really good rant about this issue. People would have been captivated. People would have read it and changed their ways.
I had it all planned out.
I ran out of an important medication I must take every day. This was not a complete surprise – I can count pills and had planned ahead enough to call in a refill to the pharmacy. However, between medical school tests, classes, and studying, I did not get around to picking up my prescription until Saturday morning. That’s when I discovered that my neighborhood pharmacy is closed on the weekends.
Now, this in itself was not fatal – there are other pharmacies in the city. Fred Meyers has a perfectly serviceable pharmacy open on Saturdays. I just needed to get a prescription.
I do not have a primary care doctor. I moved here relatively recently. I am relatively healthy and I understand that getting a primary care doctor takes a lot of work in this town. My strategy usually works out okay. My refills can be done through my old doctor in Seattle and I just needed a two-day supply. However, a quick phone call revealed what should have been obvious – my doctor’s office is closed on weekends.
The office, like most around the country these days, is also no longer staffed with someone to take calls on the weekends. The voicemail letting me know that I should call 911 if I was experiencing a medical emergency was not particularly helpful. In fact, I was trying to avoid a medical emergency. I wasn’t about to resort to 911. Instead, I decided, I’d call my pharmacy directly.
“Is it possible that I could get just two pills?” I asked. My medication is non-addictive. You cannot make meth with it. There is no high that would make it worth scamming for. I figured, “what’s the risk?” However, the pharmacy has a firm policy against such things. There are probably laws/ethics rules against it as well.
The urgent care in town was, likewise, unhelpful. They did not write “refills” and had a policy against writing prescriptions for “chronic” medications, even if you were only asking for a two-day supply.
Guess where this left me? The emergency room.
To prevent the serious potential consequences of not taking my meds, I presented myself to the triage nurse with no critical complaint and no symptoms of duress. My only request was for a prescription for two pills. Needless to say, I was not their highest priority.
When I emerged several hours later -- having wasted the time of the professional medical staff who served me without even rolling their eyes -- I had my prescription.
Every day, people in our community face the same choice I did: go into the emergency room to receive primary care or wait it out and face an actual emergency. Do they go to the emergency room to check on that sore throat, or risk waiting until there is a high fever, chills, and other serious symptoms?
There is a serious shortage of doctors. Everywhere. Many of the doctors in our region are retiring. This makes it difficult for patients to even get in to see a doctor, and this is assuming they have insurance, the doctor will accept their insurance, they can get transportation to see the doctor and have the ability to see the doctor during office hours – factors that are not always true in a mostly-rural Yakima County.
We need more doctors.
However, more doctors requires more residency programs, without which you cannot become a qualified doctor.
We need more financial support to pay primary care doctors more, increase the Medicaid payment rates, and reduce the amount of debt that students must incur to become doctors.
We need financial incentives to encourage doctors to live and practice in rural areas for years to come. These incentives and changes, unfortunately, can only come from government funding, both at the state and federal level.
So, the next time you have difficulty accessing primary care, write a letter; make a phone call. Let your government representatives know that this is a serious problem that needs a serious solution, fast. Each phone call and letter can have an impact. If enough of a representative’s constituency write about a problem, it can very quickly become that representative’s problem. So write. Email. Get on the phone. Whenever you have a problem with the healthcare system, make your voice heard. They will get the message.
Call your state representatives. In Yakima, we are represented by Senator Jim Honeyford, Representative Bruce Chandler, and Representative David Taylor. Write your representatives in the United States Congress. If you live in Yakima, that would be Dan Newhouse in the House and Senators Patty Murray and Maria Cantwell in the Senate. See below for some useful contact information.
People often forget that democracy is also a verb. You must take action to be a part of it. If you want change in a democracy, you must act. Please act.
402 E. Yakima Ave
1318 Longworth House Office Building
Washington, DC 20515
(509) 452-3243 – Yakima Office
Phone: (202) 225-5816 – DC Office
154 Russell Senate Office Building
Washington, D.C. 20510
Phone (202) 224-2621
402 E. Yakima Avenue, Suite 420
Yakima Washington 98901
Phone: (509) 453-7462
511 Hart Senate Office Building
Washington, DC 20510
Phone: (202) 224-3441