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.