This is a true story. One of my patients was preparing a birthday party for her daughter (and it sounded like it was going to be one BIG party). She was slicing avocados and proceeded to slice her hand. Her husband said, “Quick! Go to the ER!” She said “No, I’m going to see Dr. Tess!”
Being kind, she called my office to let me know that she was on her way. I was still with a patient when she arrived so she had to sit and bleed in the parking lot for a few minutes, but then we brought her in. In less than half an hour, the laceration was sutured and bandaged. When we told her the fee for the procedure, she said, “You’re kidding me! Can I at least leave you a tip?” And then she headed out the door to go back and finish setting up the party. I hope that somebody had finished slicing the avocados for her before she got back.
As I said, less than half an hour from when she came in the door. If she had gone to the ER, she still would have been waiting for triage, and depending on how serious the other cases in the ER were, she would be sitting and waiting a few hours before they finally took her back to sew up her hand. She would have missed her daughter’s party entirely.
Further, they would have charged a LOT more: not just the doctor’s fee to evaluate her and then the fee for the procedure itself, but also a fee for the ER facility which takes into account how much time the nurse spent with her and any medication given, the cost of the sutures, the cost of the laceration kit, and, if they were using reusable instruments, the cost to sterilize them.
My advice to you: If you have something that you think needs an ER’s attention, call our office to describe what you’re bringing in so that we have time to get ready for you. We will tell you whether it is something we can handle. Some people go ERs for ear infections, urinary tract infections (I know; I’ve had them and want them diagnosed ASAP), STDs, and other office medicine diagnoses. We can handle all those conditions. And we can handle the issues for which people are going to drug-store clinics. Based on what you tell us, we may tell you that it would be best for you to go to the ER (and we won’t charge you to tell you that over the phone). If you think you are having a heart attack and you come here first, we will stabilize you but you are going to get an ambulance ride to the ER. If you think you are having a panic attack, we will take care of you here but you need to know that I won’t be giving you any Xanax or Ativan. There are other ways of dealing with panic attacks besides medication. And if you come here, it will cost you much less than a trip to the ER.
In case you didn’t know, Garcia Family Medicine operates on a membership program. If you are already a member, it’s just the cost for the procedure. If you have no primary care doctor, you can sign up as a member when you come in. If you don’t want to become a member, there will be a charge for the office visit. But it’s still going to be WAAAY cheaper than the ER.