It seems my last post pissed off the primary care docs, based on the comments left. Not really my intent, but hey, it won't be the first or last time I'll unintentionally piss off a whole class of practitioners.
Every ER doc has had to deal with the patients who come in with the "positive suitcase sign," meaning that their presentation is not only not an emergency but that they took the time to pack the suitcase before coming in (more than occasionally by ambulance). It's no fun to try to turn that into a satisfying patient experience when you are going to have to deny their initial expectation of hospital admission. Sometimes it's due to a 'patient issue," which is to say that either they just decided that they are not going home, or they willfully misinterpreted what another doctor told them. Nothing we'll ever do about that. But often, they come with the maddening statement "my doctor told me I was being admitted," when no such arrangements have been made. That's much more frustrating for all parties, and easily preventable.
Both the ER and the PCPs can play a role in mitigating this problem, I think. For the PCP's, I would ask the following:
- If you are sending a patient to the ER, please call us in advance and tell us what it is you want. We're all about customer service, we just have to know what it is you want us to do.
- Don't send a patient to the ER if they do not need to be seen in the ER. Seriously, if they are stable, make them a direct admission. It saves everybody time and money.
- Make sure the patient is clear on the expectation. Don't tell them they need to be admitted unless you are the decision-maker regarding the admission (in which case, see #2). If they are being sent for a work up, please make sure that is clear to the patient.
Somewhere out there, Flea is smiling.