[dshep]

I recently took my GF to the ER because she had been stung by a bee and was worried she was allergic. She was feeling dizzy but once we were in the ER she started feeling better. They basically took her vitals, waited 30 minutes or so, gave her a steroid, and then sent us home. They told us it probably wouldn't be very expensive as she was uninsured.

Later the bills arrived: $1300 from the ER ($1900 minus a $600 uninsured discount) and $600 from the PA who saw us. Insane!

[nrclark]

That sucks, sorry to hear it. If she hasn't paid those bills yet, she can probably negotiate them way down FYI.

[Spooky23]

Generally speaking, that’s an example of a fundamentally wasteful ER visit, and why the lack of universal coverage is so dumb. That’s why ERs cost a fortune.

If you’re not bleeding, have a broken limb or other trauma or an expectation of being admitted, you don’t belong in the ER. Take a benadryl.

[function_seven]

So why doesn't the triage nurse hand out the Benadryl, tell the patient to wait in the lobby for an hour, and see if that resolves it? They could charge $75 for the single pill, and still avoid using a bed or the services of additional staff.

[bspn]

In short, liability. So much behavior within the US medical profession is driven by a fear of getting sued for malpractice. Even though the patient would be sitting in the ER with treatment close at hand, if the situation did worsen and the patient suffered complications there will be the inevitable questions asked as to why the triage nurse didn't admit them in the first instance. For hospitals it's just not worth the risk of potentially expensive and lengthy lawsuits/settlements.

[Spooky23]

That’s not how the process works for an ER. A doc in a box urgent care would essentially do that.

An ER handles everything from bee stings to shootings or strokes. They’re optimized to deal with those emergencies, not optimize cost for minor dings, especially when most of the minor issues are uninsured people who won’t pay anyway.

Emergency medicine is not a profit center, and is often mandated to exist. You’re paying for all of the lost receivables and capability.

[romwell]

>A doc in a box urgent care would essentially do that.

Yeah, and urgent care facilities usually have working hours like 8AM-8PM. Because, you know, those are the only hours people every get minor sicknesses.

[adrianN]

If it's a minor sickness it can usually wait 12 hours?

[cameldrv]

Emergency medicine most definitely can be a profit center. That's why you see all of these new freestanding emergency rooms that look like an urgent care center but are open 24 hours and bill 2x as much.

[Nextgrid]

The ER is more like insurance. In this case she was fine and got better more or less on her own but what if she deteriorated quickly? The ER would have the appropriate skill and equipment in-house to save her, whether if she was at home it might’ve been too late to make it to the ER when things actually became critical.

[khuey]

Reminds me of this: https://www.vox.com/health-care/2019/5/10/18526696/health-ca...

"Clark had to decide: Should she take Lily to the emergency room?

She called a poison control hotline and the answer was yes ...

But Clark knew that the emergency room can be expensive.

...

“I’m weighing my options,” Clark says. “She could have a seizure at any moment. It felt terrible, as a parent, to be in the position of having to do that.”

Clark and her husband decided to give Lily some activated charcoal at home and drive to the emergency room. But they wouldn’t go inside.

Instead, they pulled their car into the second row of the parking lot, about 100 feet from the entrance. They start playing The Little Mermaid on the car’s TV screen for Lily to watch. And they waited.

“We were just sitting there, facing the door and watching Lily,” Clark says. “We chose the second row because we wanted to be close to the entrance, but also trying to look inconspicuous.”

The Clarks waited in the parking lot for a few hours, and Lily didn’t show any symptoms. They drove home without setting foot in the emergency room."