What do you do when you have to wait four hours to see a doctor?

Col Rebecca Lorraine So Ma'am are you aware it is COMMON for Tricare and other health insurance providers to direct patients waiting for routine or urgent care to go to the ER? IOW, not the patients idea,,they asked to be seen by the PCM but were told no or to wait days, weeks..
Current average wait for me to be seen by a healthcare provider (not a doc, Im not privileged enough to get to see one of those) is 4 weeks.
When a gout flare up happens, something Im sure you know is excruciatingly painful and debilitating, waiting 4 weeks is not an option..
When an abscess forms, Im not dying.. but if it is not treated I may..waiting 4 weeks is not an option..
When I fractured 4 ribs 4~7 I was not dying.. but had I not sought treatment the likelihood of respiratory distress developing was high, and then i may have died.. waiting four weeks was not an option.
In ALL of those cases I was DIRECTED to go to the ER for care...because my primary care manager could not see me for weeks.
I have ZERO sympathy for a healthcare provider working at an ER that is providing me care under those conditions.. Don't like your job.. quit.. it would be better for the patient in any case to not have a healthcare provider with a chip because "their" ER is being abused by some sicko who is not sick enough in your opinion to justify using that healthcare providers time.


Of course, no one is justifying going to the ER for a hangnail...that's just silly...and I share in the health care providers frustration in those cases.. truly a waste of their time, when they cold be providing needed services. but the fact is, the ER is often the ONLY choice to be seen in a timely manner for urgent care..

SGM Erik Marquez - I did go to a Prompt care about three months ago, and they didn't accept Tricare. I had a badly sprained ankle, but it was not worth an er visit. I have Medicare and Tricare for life. So, different for me. I have to tell you the burn out rate for healthcare providers is very high in most fields. They are abused by patients, the system and everyone really expects drive through medicine. So, there is a shortage of any providers. They are expensive and I know the system doesn't support the quality of care we expect. My point is, don't go to an er and expect to be seen if you aren't dying in less than 3-4 hours based on Triage. Most insurances do cover emergent and urgent care. But again, Tricare is probably seeing patients go there for refills of blood pressure medicine. Many urgent cares have priced themselves out of the market. Greed and obamacare has impacted medicine and socialized medicine will be so much better! (Said in jest)

Col Rebecca Lorraine -Ma'am thank you for that response... It very clearly separates you from some of the ER staff I have had the displeasure of meeting that truly acted as if anything less than advanced trauma life support was beneath them as providers.

The triage and wait times are expected and reasonable, who in the right mind would want be seen on a first come first serve basis for a non emergent need while someone bleeds out in the back of the line?? No scratch that.. I bet you run in to those needy types every day..
Med refils? well I suppose if it was Nitro for heart condition and I took my last pill today, PCM said 3 weeks till i could get an appointment.. maybe... but I get your point... those seeking another 20 count of Norco because they "accidentally" dropped the last bottle in the tub while washing up great grandma post self soiling episode likely gets old... More so, because the provider knows in their mind..some good sole really did drop their meds in the tub helping granny all the while knowing the drug seeker in front of them aint that person.

Part of the "life aint far" deal is... Some of us were promised "Medical Care for life" when we entered service, that of course was a lie..now my tRICARE Prime fees re reasonable as far as healthcare insurance costs go.. but thats not the point.. I was promised health care then told to pay for it, fine I am,, now PROVIDE it. ...If YOU the provider of service tell me to go to the ER to get the services I paid for, so be it. That makes the fight for ER docs and Admin with the Insurance provider not the insured...
If the Insurance company want to cover me going to an urgent care facility, vice waiting for a PCM or going to the ER I'm fine with that/.. BUT THEY DONT. So its wait for weeks or go to ER fur urgent care...

//Rant off//

triage is the key, in er's, millitary or civi, the abillity to descerne life threatening vs mom, those in the community know this, we need to train or re evalute who does the triage, i had young person present from triage with chest pain, had well known history of cardiace problems, was immediately bounced to pediactrics educate the screeners, then nobody will die while waiting

If you waited 8 to 14 hours on a post ER you have a VERY, VERY, VERY shitty ER. I could see 4, MAYBE 6 if something happened, but 14? That is ludicrous. I worked at Langley AFB back in the 90's, and I mean ALL of the 90's and we were one of the busiest ER's in the area and people would show up for allergy medication as an appointment and we never had a wait that was 14 hours.

They finally did say enough was enough and started telling people to beat it. This is an ER, not your family doctors office.

MSgt Jonathan Stump - Well that depends. The ER here at Bliss was only originally built to see about 100 patients a day. We routinely see upwards to 140-160 on a normal day and over 200 during spikes. And since we are the ER that sees all of the VA patients in El Paso, we are also talking some very sick individuals. So yeah, if he was a ESI cat IV it may take 8hrs to be seen if we keep getting IIs or IIIs that keep presenting before we can see him.

LTC Paul Labrador - I wasn't going to name names, but Bliss was where those wait times I had occurred.

SFC (Join to see) - i wouldn't doubt it. When they expanded Ft Bliss, they did not expand WBAMC. Our patient load exploded overnight. Plus we are in a building that is close to 60yrs old, which doesn't have a whole lot of physical room to expand. The ER at WBAMC is simply not built to accommodated the numbers of patients we are seeing. When I was the ED Chief Nurse, command was obsessed with getting our wait times down. Hopefully the new hospital can better accommodate those numbers.