I remember taking my wife to the ER for a severe

headache. The ER Doc stuck his head in the door and

said “Hi” and “we will take care of you.” Some lab

work, a Cat Scan, and a shot later, we were on our way

home. The headache was no better, but after a good

night’s sleep it was gone.

Some weeks later, I got the mail and noted a bill

from the ER. I tore it open and was fl oored by the bill.

We paid the ER Doc $700 (for those 7 words!), the ER

got $3000, radiologist got $100, and the Radiology

Dept got $1000. This was 10 years ago.

Now, it is not unusual for me to hear about a $7,000

bill from the ER. An admission to the hospital? $30,000

easy. I went to a meeting and we were discussing the

relative costs of outpatient versus inpatient care. The lecturer informed us that we could see

a patient with a chronic illness EVERY DAY in our offi ce and it still not equal the cost of

one hospital admission. Let me repeat. I could see someone 240 times a year and the money

would not equal to ONE hospital admission!

So how do you know when to go to the ER? I can tell you some general guidelines. If

you have chest pain that is not clearly refl ux, then go to the ER. If you have numbness,

weakness, double vision, or diffi culty speaking, then go to the ER. If you have unexplained

shortness of breath, then go to the ER. Otherwise, go if you think you need to. Even better,

go to the ER if your doctor tells you to go.

I suppose the most cost-eff ective way to avoid the ER is to get it taken care of in an

outpatient setting, but that is often impossible. I suspect it wouldn’t be as hard if a few of

those hospital dollars found their way into the outpatient clinics. Unfortunately, that really

would take an act of Congress.

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