Thursday, June 17, 2010

A New Quality Control Initiative

This one's from me.

From this day forward, I propose that all ERs and hospitals provide complaint forms to their physicians and nurses. We would be encouraged to fill them out after a particularly trying patient encounter.

For instance, had I access to these forms I would have taken two and filled them out on a middle aged couple who demanded ambulance transport from the scene of an accident. See, the paramedics are pretty good at assessing damage to vehicles and severity of mechanism. This helps me gauge how worried I need to be at the beginning of the evaluation of trauma patients.

All trauma patients arrive on a back-board and wearing a C-collar so with some exception all trauma patients look the same. This couple came in with head to toe pain and the paramedics informed me that not only was the car not even SCRATCHED, but that one of the troopers drove it here to the hospital so the patients could drive it home after the evaluation.

Nothing about their complaints matched up with the accident. It them became incumbent on me to document the complete lack of injury so we did more XRays than we needed to (none were needed based on the accident) and labs to boot. My chart will not be very helpful to the plaintiffs attorney in the law suit against the other driver.

I was told today that the two had complained about the care they received here. Why is there no mechanism in place for me to complain about them? For the city to recoup the cost two wasted ambulance transports? In other words, where is the disincentive for this kind of behavior? There is NO DISCINCENTIVE. Perversely, there is a great incentive to abuse the system.

There are no prosecutions for fraud, no prosecutions to recoup wasted money, and no ability for me to walk into the room and say 'no'. Thirteen hours and all of this is someone else's problem. My new job starts in ten days. More soon.


  1. #1....hang in there just a little bit longer. addition to the pronouncement of G. House, MD, that "everybody lies" we will add that "everyone is trying to get something for free.

    #3...why, I mean REALLY, w-h-y do we send PG forms to Medicaid, no-pay, and/or malingering patients?? Do we CARE if they are happy?? Do we WANT them to come back? If I were Queen, PG would go away, or at a minimum only go to reasonably sane paying patients with a valid medical complaint.

    Pattie, RN

  2. 911...

    wishing you the best in your new endeavor

  3. I feel your pain. At least you are not an RN. When we get complained about we get reemed by the patient, the physician, nursing supervisor and administration. And I totally agree with everything you said.
    Lucille RN

  4. thanks lucille,
    but if you are getting grief from doctors about inane patient complaints then you are working with jerks. obtw, have you heard the new way we say someone is 'self pay'? they have New-Orleans-New-England insurance, ie NONE.

  5. OMG I don't want to believe this...but working in the ER, I would be stupid if I did not. Hope everything works out 911!

  6. ...can I add in the issue of the "VIP" patients? They are the ones, in this case a low level politician's wife who wrote a scathing letter about how rude the PA, nurse etc were. All the while reminding anyone who'd listen about *who* they were, and in their complaint letter wrote about *who* they know...

    I personally don't give a fuck if they are related to the Pope. The physically sickest patients get seen/treated first. The emotionally sickest (ie: the one's who are there to get their pathetic egos stroked and asses licked) get seen next.

    I meant to remind them that it's MY tax dollars paying their salary, pension, cadillac insurance plan for life, etc.

  7. C'mon when Life gives you Lemons, make Lemonade, and add some Cyanide, I mean, keep a smiley face.
    I love those Complaint Forms, fill em' out all the time, and after enough "the Doctor didn't Speak English or Listen, and fondled my junk even though I came in for a sprained ankle" the ones they fill out about me wont sound so bad...
    Sometimes I'll give em the forms myself, like Jim Carrey did on "The Cable Guy"...


  8. Ugh, I hate these types of people. My daughter tapped a guy last year - and I do mean tapped. We all had to lean in to find the scratch. The little twerp ended up being an out of work salesman and took my daughter to small claims after he'd racked up all kinds of bills to treat fake pain. His chiropractor was all too happy to provide his client/friend's true suffering.

    Phucker actually got two grand for his car damage" and "medical bills." I told him his mother should be proud to have raised a phucking parasite.

    Good luck with your new endeavor, 911!

  9. priceless1 - That happened to my daughter too - two accidents in one day, though, and her car was totaled.

    First accident was a fender bender on the way to work. She was at fault. Not going fast enough for the air bag to deploy, but was following too close in stop-and-go traffic and did not leave enough distance. There was a scrape on his fender (he was driving a large SUV, and she a Miata, so the Miata got the worst of it). They exchanged insurance information, but he didn't want to stick around to file an accident report and told her that it was just a little dent ... no big deal and don't worry about it. He made a bee line for his lawyer's office apparently (who "has" a lawyer?), and then saw a doctor for pain medications. He wanted prescription pain killers and medicinal marijuana! The insurance company took care of him and all he got out of it was some extra-strength Tylenol (and a new bumper). It was my daughter's first car accident. She was rattled by it ... and hopefully learned something from it!

    The second accident happened on the way home when a woman rear ended her at a stop light. Only this woman was completely whacked out on drugs, was going much faster, and had an unrestrained toddler in the car with her. Interestingly, she was driving a new car with the dealer plates still on it. She apparently passed out while driving and came to when she hit my daughter's car. The police took her away in cuffs and child protective services confiscated the child. My daughter said she felt awful for the baby, who was smiling and happy and oblivious to the corner his life had just turned. Back end of daughter's car was smashed in, and they ended up totaling it. Fortunately, the woman had insurance! I was a little concerned about my girl, since the day after the accident her back and arm were hurting. She didn't do anything about it, though, and it went away within a week. One good thing that came of that accident is that my daughter is driving a more sensible car now. She is in California, and while she never had much of an opinion before on legalization of recreational drugs ... she's pretty opposed to it now!

  10. I work at a community health center where patients are charged five dollars for prescriptions. Occasionally at a follow up visit a patient will say that they didn't take the prescription because they "couldn't afford it." So in the face of cell phones, designer purses, and so on, once in a blue moon I respond by saying "Do you expect me to believe that?" A few written complaints have been filed with admin for this. What do you think?

  11. "no fault" is an abomination.

  12. dear anon,
    i think it's a result of two over-arching forces...
    1. the victory of relativism as a governing philosophy in our country. this boils down to the belief that there is no 'right' and 'wrong', only personal preference. it is therefore not relevant that people are lying to us for their own benefit... it's just their way.
    2. politicians understanding that to stay in power they have to dole out goodies. combine 2 with 1 and no one cares... no one can stop it.