Tuesday, June 10, 2008

Light At The End Of The Tunnel?

Looks like heading to the ER because of chapped lips won't fly any longer in the great state of Utah.

Utah's Medicaid program has received federal funding to help develop a program to divert Medicaid patients from the ER for non-emergent problems to primary care providers. This novel concept seems to make some sense, eh?

Created by the Deficit Reduction Act of 2005, about $50 million in grants will help Medicaid programs in 20 states fund local and rural initiatives to provide alternative health care settings for individuals with non-emergency medical needs. About friggin' time.

Hang in there 911 Doc and Shrodinger's Cat. The cavalry may be coming after all!


  1. Lofty,

    Do I hear you saying, "We are from the government, we are here to help?"

    Pardon me if I'm not excited.

  2. Yes, like, if the government is running it, it should work like a charm. Right? Right?

    Of course, when they try to send all the Medicaid patients to primary care clinics they will find a shortage there, too.

  3. It's gotta help a little right? Anyway, I don't see how there could be a solution created that will instantly fix anything. It will probably take baby steps. Lots of baby steps. Here's to hoping the medical establishment can hang on.

  4. And this will restore the earth to its place in the center of the universe, birds will chirp all of the time, nobody will get truly sick, . . . .

    OK. I am a bit skeptical, but isn't this essentially what the fast track part of the ED does already?

    Moving it farther from the ED won't make it easy to reach by ambulance.

  5. Yes, and Medicaid patients will start pooping ice cream for you after their visits in the ER.

    Peace will be restored in the Middle East - can you restore that which never existed?

  6. Discord in the Mid East is a necessary ingredient for Armegeddon, and we wouldn't want to mess with that, right? I feel secure enough to renew my Tivo subscription for another month at least.

  7. Month to month is much safer, but when the end comes, we won't need money, will we. :-)

  8. No, but I want to watch Battlestar Galactica until the hoof beats and trumpet drowns it out. Actually, I read closed captioning, so there's no conflict.

  9. I would go to a pay cash up front ER. Especially if I didn't have to wait 8 hours to make sure my Son isn't having an appendix problem...Maybe they could give you a frequent flyer card too. They could put it on my key chain with all the other little cards from CVS, Borders, Stop and shop, ETC, etc,,

  10. OK. I am a bit skeptical, but isn't this essentially what the fast track part of the ED does already?

    Fast Track is billed as a regular ER visit, at least in our hospital. Fast Tracks are being built so the non-urgent people don't leave TO go to their clinic due to the wait.

  11. nurse k dittos. fast tracking ER patients is difficult. in my last hospital we had a 'fast track' where we were supposed to turn and burn the 'quickies'. it was a dangerous place to work a shift because when the regular 'sick' beds got full they put folks in 'fast track' that 'weren't sick', nor was the fast track equipped to take care of sick patients. pretty soon they were putting cardiac monitors over there, and then they created a 'half fast track' for the 'iffies' and then it was the same as the main ER.

    working the fast track was scary and the first thing i would check was which nurse was in triage. some nurses don't believe that anyone is sick and some believe everyone is sick and i admitted many a 'fast track' patient to the ICU.

    then there's the other problem. for patients who are 'kinda sick', who fall out of triage parameters for fast track, they sit out in the waiting room and see tens of people go back to fast track while they wait for a 'regular bed'. they then complain and since our masters seem to only care about complaints the fast tracks seem to generate more complaints than they are worth.

    it's like the mail, it just keeps coming, and coming.... (newman).

  12. Don't know how it is supposed to work in Utah. In North Carolina medicaid recipients visiting the ER must receive approval for the visit from the primary care doc. Good idea, right?

    If the PMD refuses, the patient has the option of being seen and assuming responsibility for the bill. (If you believe they will, I have some swamp land to sell you!)

  13. frankers -

    You mean a psych who doesn't overrx? Someone who doesn't diagnose your neighbor's two year-old with BPD, schizo-affective, AND?
    Someone who knows a faker? That evaluator who kicks out the homeless guy looking for a place to do his laundry?
    You mean that every teen who is slightly depressed, slightly confused, isn't depressed? doesn't suffer from borderline personality disorder?


  14. I'm just disappointed that Utah is the light at the end of the tunnel. The last guy that espoused that belief was hung in Illinois by an angry mob. Next thing you know we'll all be wearing magical undies too!

  15. We're getting this where I work. Nurses in our dispatch center, taking 911 calls to keep stupid shitbags from clogging our ambulances with tooth aches, gout, and medication refill requests.

    How long till these idiots realize they can just say, "I gots me chest pain" and they'll get an ambulance is beyond me. I give it 2 hours.