quote:

Originally posted by ZSMICHAEL:
How many of you know where the nearest Trauma level one center is located??

2 of them, about 10 miles as the crow flies. OU Medical for Adults, Childrens Hospital for Pediatric Level 1.
.

Wow
75 miles away for me , by Helo.
U of Iowa Hospital
up in Iowa City.

Three trips to the ER and didn't see a doctor.

Day 1: I tore my meniscus. Very bad pain and leg swollen like a balloon. I go to ER #1 and wait and wait. Finally I see a PA who orders an xray of my knee. Nothing is wrong with your knee sir, here is a shot of demerol.

Day 2: I sleep a lot. Wife buys me a cane and I call my doctor and leave a message.

Day 3: Pain and swelling again make me cry. I go back to ER #1 and wait and wait. ER PA orders CT scan. There is nothing wrong with your knee sir, here is a shot of demerol.

Day 4: I call the Dr. that gives me back injections. This office is great and I talk to a nurse for a few minutes. She is concerned about the swollen leg and thinks it may be a blood clot. She tells me to go to ER #2 for a doppler scan and she will have the Dr. call them to expect me. I arrive and and there is zero wait. Getting up on the bed causes me tears. The PA says, you shouldn't have to be in that much pain, here is a shot of morphine. They do the doppler and I don't mind as I am high and a cute 20 something nurse is maneuvering my jewels to get a view of my femoral artery. No clots.

Day 5: My Mother in law suggests I go see an orthopedist. I make and appointment.

Day ?: About 2 weeks later, I see the orthopedist and he orders an MRI and gives me an injection in my knee which helps a bit.

Day ?: About another week later, I have the MRI. The orthopedist calls me and says I have a major tear of my meniscus and we schedule surgery.

Yesterday: About 3 weeks after the last appointment, I get the stitches out from having Arthroscopic surgery on my knee. I feel better and swelling is gone.

All of this could have been avoided if I saw a Dr. on the first visit.

Florida has 10 Level 1 centers, ORMC Downtown for our area, 27 total listed Level 1 and 2 centers.

Much of this is predicated on Obamacare, it's acceptance by many states has increased the number of people who have "insurance" via the expanded Medicaid provisions that states were required to accept by the Feds if they wanted the money the Feds were going to give them to expand it.

Kentucky was a perfect example as the governor accepted this money, rolled out the enhanced Medicaid coverage which in turn sent massive numbers of people without primary care physicians (another shortage issue) or the money to pay for a primary care visit, so where do they go... The ER, for everything, jamming up the place, slowing response, taking up resources and increasing the costs of operations, all while treating patients at the lower billable rate of Medicare.

It's no wonder ER's are looking for ways to manage costs. Articles like this always pitch the "profit bad" angle, but these are for profit institutions, and profits allow them to grow. With Profits you can borrow money, build new trauma centers, a wing for cancer, new technology, replace old equipment, pay for experienced talent.

I can see where ER's are looking to change things around, when Obamacare came out many states such as Kentucky bought in big time, accepting the provisions to increase the Medicaid access, this was done because 1) Feds sent states a big check, 2) To increase the number of "insured" being reported for the press.

The result was a flood on ER centers in the state overwhelming the facilities as people began using ER for everything, basically there were not enough available doctors in the state to take on the newly "insured" patients that take Medicaid.

If you can use funds to get 4 nurse practitioners who can handle low level cases that don't really need a full time ER doc to deal with you can use the same funds to improve access to care to more people. Not everyone going into an ER is a heart attack stroke or level 1 trauma patient. Many are simply sick people without primary care access.

This same tactic of using NP's to handle low level cases reduces the load on the ER doctor to concentrate on those cases that need higher level of expertise.

The article is from CNN about what happened after O-Care came about and KY agreed to the new rules for the payout. This is what is happening nationwide.

Link

quote:

Originally posted by ZSMICHAEL:
How many of you know where the nearest Trauma level one center is located??

6 total. I've got 3 withing 25 minutes, another 45 minutes and 2 more within 75 minutes driving.

Right around the corner currently. From our planned retirement address in AL, 2 hours in every direction at least.

I expect to need a trauma center more when on the road than while sitting at home, making it a crapshoot.

Now Level 1 Stroke Center...... oh; same distances now and in retirement as Trauma. Couple Level 2 nearby retirement , but that service is more likely for the oldsters.

xd45man, wow. You went through the wringer! E mail me if you don’t mind on who fixed you up.

Nearest level 1 trauma center to me, Shalimar, seems to be USA in Mobile. After that either Birmingham, AL or Gainesville, FL.

quote:

Originally posted by HRK:

Florida has 10 Level 1 centers, ORMC Downtown for our area

I believe that you are correct, re ten Level 1 facilities. I looked at ORMC's website, and they make the incorrect claim that the downtown Orlando facility is the only Level 1 trauma center in the state.

A physician friend of mine suggested that the motto for Florida should be "God's waiting room."

quote:

Originally posted by ZSMICHAEL:
A physician friend of mine suggested that the motto for Florida should be "God's waiting room."

That's been trademarked and registered by the St Pete/Clearwater Chamber of Commerce for 40 years...

quote:

Originally posted by ZSMICHAEL:
A physician friend of mine suggested that the motto for Florida should be "God's waiting room."

I had a short stay in an over 55 community in Mesa ,Az
One neighbor welcomed me too
Gods Green room

quote:

Originally posted by HRK:

quote:

Originally posted by ZSMICHAEL:
A physician friend of mine suggested that the motto for Florida should be "God's waiting room."

That's been trademarked and registered by the St Pete/Clearwater Chamber of Commerce for 40 years...

Almost as old as "Home of the newly wed and nearly dead."

quote:

Originally posted by Appliance Brad:
I haul a bunch of people to the ER. Most of them would be fine being seen by a PA or NP. But then, most don't need to go to the ER regardless.

"OK, on a scale of one to ten, ten being the worst thing you've ever experienced, how bad IS the pain in your big toe? Ten, you say? And it's been bothering you for three days? No, no... you were perfectly right to call us now. At 2:00am. On a Saturday night. No, your adult daughter can't ride to the hospital with you. No, you won't really go to the front of the line at the ER just 'because you came in on an ambulance.' No, she's wrong if she told you that. No, working as a CNA doesn't make her an authority on this. No, my supervisor can't speak to you right now. She's solo in a Quick Response truck and responding to a different Level 10 Toe Pain emergency across town."

Sorry for the thread drift. Hot-key issue.

Hospitals have cut psychiatrists from the ER who used to handle lots of issues. In many ERs the ancillary staff has to deal with these things, with no more training than a beat cop.

quote:

I had a short stay in an over 55 community in Mesa ,Az
One neighbor welcomed me too
Gods Green room

^^^^^^^^^^^^^^^
Like in the waiting room to go on the Carson show?