I have a Medicaid client that has been going to the ER about once a week to get a paracentesis (fluid drained off the abdomen) due to Cirrhosis of the liver. He has been going to the ER because he was having a tough time finding a Primary Care Doctor who would take Medicaid. He usually gets 8 to 10 liters drained off each time he goes in for a procedure.
The Doctor did do the procedure but would only remove 2 liters of fluid from my client. My client begged the Doctor to please take off 2 more liters, but he refused.
Each time this procedure is done it puts the patient at risk for an infection, and there is a chance of puncturing an organ. I was told today on the phone that the concern was my client is “chronically” using the ER for this procedure.
I could not believe what I was hearing. My client will now have to go have this done again tomorrow, for no good reason. The hospital treating him is a Magnet hospital and therefore has been given special recognition by JACHO (Joint Commission on Accreditation of Healthcare Organizations), and therefore is held to higher standards of care.
Another client went to the ER last week because he was in a motor vehicle accident. The doctor at the ER discharged him and said there is nothing wrong with him. He called me complaining of severe pain in his chest area, dizziness, headache and nausea. I went with him back to the ER. He has a concussion, 2 broken ribs and torn ligaments. The hospital never even did an x-ray of is ribs the first time.
If this is any indication of the quality of care, or lack thereof, we should all be seriously concerned.