Crestwood Emergency Room Complaint - Quality Of Treatment

Review by Raybud on 2009-01-28
HUNTSVILLE, ALABAMA -- On 12-7-08, at about 6:30 am,{sun}, I went to the Crestwood emergency room with back pain and some blotches around my mid section. After x-rays the doctor came in the room and started typing on the computer, asking what the problem was. I told him of the pain, the blotches to include the lower rib on my left side had swollen to twice its normal size. He said I'll go check to see if that rib is broken. He did not have time to check but returned and said it's not broken. Not once did he examine the rash which later turned into full blown shingles which was later confirmed by another doctor at Huntsville hospital emergency room. If he had diagnosed them properly I could have been given a drug that would have cleared them up in a week to ten days. S a result of his incompetence I have had two other ER visits, numerous drugs, unbearable pain and discomfort, loss of work, and in a few days I will enter into the third month of this pain with no relief in sight. The doctor's name is [snip - no names please]. Taking into consideration the time of day, the fact that I am a 73 year male on Medicare/Tricare for life, his only intention was to get rid of me in a hurry. The discharge procedure was another farce, but that is another story.

I just hope that nobody else has to go through what I have had to endure at this place.
Comments:27 Replies - Latest reply on 2011-11-08
Posted by jktshff1 on 2009-01-28:
You are leaving yourself wide open mentioning the Dr's name.
Posted by hello dolly on 2009-01-28:
Why do you keep going to emergency rooms? Don't they have regular Dr's offices in Alabama? I can't imagine that an emergency room doctor would be the best choice to go see for a rash.
Posted by jktshff1 on 2009-01-28:
hello: "73 year male on medicare/Tricare for life".
No copay, no appointment, etc.
Posted by Anonymous on 2009-01-28:
BA jkt!
Posted by Disaster Worker on 2009-01-28:
As a medic, I may have a little jaded view of emergency rooms. While a rash with pain shouldn't warrant an ER visit for most, since this person is 73 years old, it could have been something extremely serious. It makes no difference who is paying the hospital bill, every American citizen should have equal access to medical care.

ER doctors see so many patients and have to make immediate diagnoses that they often overlook simple explanations for illnesses.

I think we all can give this OP a break and not smash his post. Shingles are extremely painful and can be deadly to the elderly, the very young and those with a compromised immune system.

Hope you get well soon!
Posted by Anonymous on 2009-01-28:
As a physician, I was taught "When you hear hoof beats, think 'horses' and not 'zebras'." It's best not to apply the standard of 'could be something extremely serious' to all complaints, since it 'could be' applied to every illness/symptom. Graveyards are not filled with the bodies of 73 y/o who died of zoster. But saying so makes a wonderful bully-pulpit to shout for the cause of 'equal access to health care'.
Most medium/large cities have 24/7 acute care clinics (Doc-in-a-Box). Walk-in clinics (often hospital supported) are nearly universal for small towns and rural areas. This should not have been an ER visit.
The diagnosis jkt made was 100% correct. When people don't have to pay the $300-500 ED charge, plus the $125 physician charge, plus the $100 lab charge, plus the $150 x-ray charge, etc. ...they will opt for the emergency room...because they don't have to pay for it.
The largest abusers of EDs are Medicare/Medicaid/and the suit-proof uninsured. Since DW asserts it 'makes no difference who is paying the hospital bill' he/she can send his/her contribution to the hospital that provided the OP with care. It will be appreciated.
Posted by Anonymous on 2009-01-28:
Excellent answer Disaster Worker. It's obvious you know your stuff.
Posted by Anonymous on 2009-01-28:
Good morning, Tovarich. Where ya been Crabs?
Posted by BokiBean on 2009-01-28:
Raybud, I feel your pain. Literally. The faster you can get in to see someone with shingles, the better your outcome is likely to be..but that's not a guarantee.

Frankly, I'm a little sick of people taking up for overworked docs at ER's..they have an obligation to treat patients as people who need medical care, not people who are whiners or looking for a pain pill.

My brother was taken to the ER (in addition to being under a doctor's care) on the last night of his life and my mother was made to feel overprotective and a worry to the staff. Of course, she'll be living on the proceeds of that ghastly foulup for the rest of her life, but that's little recompense.
Posted by hello dolly on 2009-01-28:
On my last experience with an ER I took my husband not because he was in extreme pain or even badly injured but rather because i could "feel" something was wrong. I felt silly going to the check in desk but was treated with respect and concern at all times.

The ER dr saved his life - truly. It turns out he had an as yet undiagnosed case of Myasthnia Gravis and was in the throes of a complete melt down. He spent 5 weeks on a respirator in ICU with many weeks of rehab following.

While i am not in the medical profession in any way I would say all ER personel is trained to treat the obvious and see past the harder to detect but really a "rash" can be a multitude of many simple and major things - go see you primary care physician.
Posted by Disaster Worker on 2009-01-28:
Ghost, while I agree somewhat in what you say, we often transport patients with seemingly innocuous symptoms but in fact are extremely ill. Pre-hospital providers do tend to err on the side of caution. Yes, ER's are full of patients that should have been seen by their doctor in the office. However, on the flip side of that, it's often difficult to get in to be seen by your personal dr. We'll just have to agree to disagree on this post.

Are you still practicing?
Posted by Anonymous on 2009-01-28:
Good point DW. As a former EMT --we often found that the patients experiencing mild symptoms were having a full blown MI, and the massive complainers ended up having something like heartburn.

In the field we don't have all the diagnostic tools that the ER does.

Posted by Anonymous on 2009-01-28:
DW...I agree. It is appropriate for pre-hospital and/or dependent practitioners to err on the side of caution. I've cleaned up after many nurse practitioners and PAs who failed to do that. A real-life "House" would last about 3min in a post-payment review by a third-party payer. I am semi-retired and focus on mentoring new docs and practice management. Consequently, I have a lot of time to spend here ;-)
Posted by Anonymous on 2009-01-28:
It's not just the lack of equipment in the field, MM. EMTs/PAs/NPs and such are not doctors...it is best they remember their limitations in training and experience. Mid=levels have a wonderful place in medicine, but should not be equated with 'physician'.
Posted by Anonymous on 2009-01-28:
Doc, you are right. There was nothing more scary than one of my fellow co-workers making an assumption about the diagnosis. They would convince the pt that they didn't need any treatment.
That often resulted in lawsuits.
Posted by Anonymous on 2009-01-28:
OTOH...I knew two EMTs who were both former combat medics, looked like they would be the first to raid the Class III cabinet in the ER, and spoke to each other in grunts. If I were REALLY sick...I would want to look up from the cot and see them looking down at me.
Posted by Anonymous on 2009-01-28:
I used to work in a hospital. I never cared if the patient in front of me was able to pay or not. They got my best efforts, period.
Posted by Disaster Worker on 2009-01-28:
All great points! It always goes back to your system's protocols, your levels scope of practice and remembering the ABC's. I just wish we could get the nurses in our local LTAC's to learn the difference between respiratory distress and respiratory arrest.
Posted by Anonymous on 2009-01-28:
That is as it should be, sherdy. The folks who don't want to wait for an appointment or don't want to pay for care know that too. ER abuse accesses them to the best care, when they want it, and often it is 'free'. The OP could have gone to a doc-in-the-box or other acute care facility. The only reason many hospitals don't offer 24/7 minor acute care? Turf battles between the ER admin and the non-emergent acute care admin.
Posted by Anonymous on 2009-01-28:
I'm not entirely hard-hearted. I pitched an intern off my service when he charted "IWU c FTWBx". I had never seen that notation. I asked him what it meant. He replied, "insurance work-up with full-thickness wallet biopsy"...he thought it was 'funny' to see if a patient could pay for a service before he got it. It wasn't. The worst of the OPs misuse of the ED was that really sick people were triaged around so his shingles could get a peek at his convenience.
Posted by Disaster Worker on 2009-01-28:
Doc, at some of the larger hospitals here in Dallas, a medic will triage and non-emergent cases are sent to a side that has a PA. Works well and frees the doctors for the "real" cases. I guess the IWC c FTWBx kind of equals "GOMER".
Posted by Anonymous on 2009-01-28:
That's a good system. It's not that I dislike the PA/NP concepts. They are excellent physician extenders when supervised. In my book, that a doctor reviews the PA/NP chart a day or two after the patient visit is not 'supervision'. Supervision is if the PA/NP runs a preliminary SOAP past a doc who evaluates the Observations, checks the accuracy of the Assessment, and concurs with the Plan.
Posted by Disaster Worker on 2009-01-28:
So true!
Posted by jktshff1 on 2009-01-28:
pa/np...ed...iwc....soap opps, I know what soap is, would ya'll talk so an old southern boy can understand?
Posted by Anonymous on 2009-01-28:
jkt...I'm southern...here's my Dixie Medical Dictionary:
enema..."not my friend"
barium..."is done with dead patients"
Posted by jktshff1 on 2009-01-28:
Doc, lol! somehow I knew that!
Posted by winnerlines66 on 2011-11-08:
Of all the Physicians I ever worked with who are associated with Crestwood Hospital one was excellent. The others were downright incompetant. Plain and simple. I have met any Doctors throughout the USA and it's no secret that Alabama has some of the worst healthcare in the country. Never once have I seen preventive medicine being practiced in this state.

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