Re: [轉載] 急診醫師的價值
美國的急診是這樣的, 這是全世界最好的急診
(by Steve Sanders, DO)
Mike was seen at our local emergency department on a Friday evening
with complaints of indigestion. (pepperoni pizza)
He worried about heart disease and called 911.
Physical assessment by the emergency resident physician came
quickly followed by an EKG, chest x-ray, CT scan of the chest (“
they said I might have had a blood clot”), and lab, specifically
including cardiac enzymes. Mike said his only complaint was it took
over five hours before he heard any news.
“Everything looks good,” said the resident. "but my attending
thinks you need to stay for a chest pain evaluation. Your
first cardiac enzyme was normal, but he thinks you need another
evaluation in six hours followed by a stress test,"
Mike said he tried to protest, wanting to just go home.
“Then you'll have to sign out AMA (against medical advice). We
can't be responsible if you go home and have a heart attack and die,”
The thought of dying at home also had him upset. He stated when he
told his story to the Hospitalist, she just shook her head and
laughed. “They just don't want to get sued,” she explained. “We
get these normal cases all the time. We try to tell them this can
be handled on an outpatient basis, but what can we do?” She
laughed again, which Mike took as a good sign he was really okay.
He left the hospital the following Tuesday—the heart scan machine
was broken on Monday—with a clean bill of health and a diagnosis
of “gastric reflux”
-------------------------------------------------
美國帳單!
ambulance ride
+ emergency department evaluation
+ hospitalization
+ cardiac stress tests
came to just under $11,000.
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