Guest ral Posted March 18, 2011 Share Posted March 18, 2011 I cover a small town ED (solo, 24h shifts). There is a family practice clinic within the hospital building. They have decided to extend the clinic hours by offering walk-in care there for an extra two hours beyond normal operations in the evening. They are requesting that my colleagues and I work those two hours seeing clinic walk-ins, while also remaining available for emergency room presentations on the hospital end (basically a walk down the hall). Without getting into all of the compensation, extra work, extra tired ramblings, are we legally allowed to cover both stations at once, as the primary provider of care at each location? Thanks Link to comment Share on other sites More sharing options...
Just Steve Posted March 18, 2011 Share Posted March 18, 2011 I have no answer but I am confused...why not just see the walk ins in the ER? Or is it a billing issue? Could the walk ins check in at the family practice clinic, then be directed to walk down the hall to the ER? I assume you're talking something like a 5 bed ER....could the walk in's overwhelm your ER space, taking beds that may be needed for an acute need? Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 18, 2011 Moderator Share Posted March 18, 2011 as long as ER takes priority can't see the harm - crazy thing is why extend the office hours when the ER is right there? better reimbursement in the ER -course a lot more for the patient in expense though Link to comment Share on other sites More sharing options...
treejay Posted March 18, 2011 Share Posted March 18, 2011 as long as ER takes priority can't see the harm - crazy thing is why extend the office hours when the ER is right there? better reimbursement in the ER -course a lot more for the patient in expense though Should the goal of medicine be to provide quality, affordable care to patients or to maximize income and compensation to the hospitals and providers? Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 18, 2011 Moderator Share Posted March 18, 2011 Should the goal of medicine be to provide quality, affordable care to patients or to maximize income and compensation to the hospitals and providers? obviously the latter - however this is a bit of a strange solution if you think about it - as soon as it gets busy the clinic patients are triaged far below the ER patients (as they should be) and then they just sit their thinking they should be seen but waisting time.... also, when you start to share staff across lines like this it tends to make things very confusing...... a patient with no insurance can't be seen a the clinic because they are not a patient there so they must go to the ER (and see the same person) for their 3 days of sore throat but then they face 3x's the expense yet someone that is a patient at the clinic can go the other way, and still see the same provider. I am all about cost awareness, just seems like a poorly thought out plan.... Link to comment Share on other sites More sharing options...
Guest ral Posted March 18, 2011 Share Posted March 18, 2011 Agree with the "poorly thought out plan" remark. The hospital, who owns the clinic by the way, wants to impress upon the community that they are moving forward in their commitment to provide services. I contend that the same people who show up at the ER now, will continue to show up. They have no intention of using the clinic. That costs money! The rest of the folks suddenly don't have to take off work or school, or wait for their spouse to get home from work to watch the kids while they 'run up to the clinic'. They'll just wait until later to use the convenient walk-in option. I foresee a clinic waiting room with twenty patients who show up at five o'clock, and we get a couple of time consuming cases in the ER. At seven o'clock, do I just walk over and say, "Sorry, clinic is closing. You'll have to come back in the morning to see the usual folks."? Guess where at least half of those patients are going to go? Now, non-ER patients are going to decide that it can't wait, even though they presented to a non-ER location in the first place. It's going to be a royal snafu. Did I mention that we don't do medical screening in our ER because it would upset the community? That's right. Don't educate them. Be at their beck and call at anytime. Would hate to have someone in the community start spreading the word about the horrible hospital who wanted to make them pay for treating their currently asymptomatic three month hx of an intermittent tingling in their right index finger at two-thirty in the morning. Makes me want to go do geri-psych. Link to comment Share on other sites More sharing options...
Just Steve Posted March 18, 2011 Share Posted March 18, 2011 currently asymptomatic three month hx of an intermittent tingling in their right index finger at two-thirty in the morning. Lateral or medial aspect? Or the whole finger? Does it disrupt their nose/ear picking or do they drop their cigarette on their new pajamas when smoking in bed because of the twinge? :-) I work as a paramedic. I am bound by county contract to transport ANYONE who calls for it to an ER. I laughed at your example as I just got back in service from a very similar case...When I hear speak of health care reform I WOULD LOVE to see it start on the streets and in the ER. But I digress Link to comment Share on other sites More sharing options...
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