Conversations from the ER Where Patients are Refusing Recommended Treatment…

Might this have any cause on the reason admission are down? People are walking out and refusing services as they are afraid they can’t or won’t be able to pay. Overall it sounds like all the preventive care we have been trying to build is falling down the tubes in a hurry with the economy.

Excessive Incentives and Rules – Where Did the Wisdom Go in HealthCare?

When you see this type of activity, we need a government insurance plan, and I don’t really care what the insurers have to say about it as hospitals are going broke taking care of those who cannot afford healthcare or insurance, so we need something that fills the bill. With all the new technology and tests we have today, it’s a shame that more can’t benefit from all the dollars spent on R and D and the brilliance of those who devoted their time to lifesaving ventures. Risk management in it’s present form and business model is not what we need for healthcare reform. BD

Medical crews told him he needed a blood test, chest X-rays and probably a CT scan to check for head injuries. And he certainly should have had treatment for major road rash, including raw scrapes on his face, neck and hands.

But the 31-year-old editor for a design magazine was between jobs, briefly without health insurance and afraid of being stuck with a sky-high hospital bill.

The doctor on duty dismissed Ashlock’s questions about cost, telling him she was “a physician, not an accountant,” he said.

Even as rising unemployment strips people of health insurance, sending many to emergency departments for care, doctors on the front lines say the lingering recession is also prompting an unexpected outcome.

More patients, they say, are refusing potentially costly procedures ranging from tests to confirm heart attacks to overnight stays to monitor dangerous infections. Just last month, Lackey saw a woman with bronchitis and pneumonia with life-threatening oxygen levels who refused hospital admission because she had no insurance. Even when Lackey arranged for her to have an oxygen kit to take home, the woman turned it down because of the cost. “She refused, saying she would share her husband’s oxygen,” Laskey said. “Ultimately she left without the oxygen or an admission.”

Several emergency department doctors said they see many more reluctant patients than they ever sign out against medical advice.

“If it’s a really dumb decision, I’ll sign them out AMA,” Chawla said. “Cardiac is one of the big ones. We’re very cautious about the heart.”