ER Warning - Do you just basically go to an Urgent Care Center instead?

[Anonymous]

The critical info we are missing here is what type of cut it was (length, depth, angle with muscle and skin tautness, etc). I would assume that any type of experienced professional, whether PA, nurse, doctor, would be able to call in the right person. One crucial point to remember is that the diploma does not matter in these circumstances - only the amount of experience. Someone who stitches every day in the ER will do a better job than someone with less practice.

Do not make blanket generalizations like this OP.
It makes you look stupid.

[Anonymous]

Anonymous wrote:CRNA here who previously worked in ER when I was an RN. PA's and MD's stitching skills are interchangeable. They both stitch just as frequently. A good care provider will know when a plastic surgeon needs to be called. If they said it wasn't necessary I would tend to agree. You are always allowed to leave and pursue a plastic surgeon yourself either by making an appointment or whatever avenues are available to you. However in my experience you can't call plastics too often (like unless its really needed) or else they will stop serving the ER all together because it is too time consuming.

sorry we have to ignore your first hand experience...here on DCUM we don't like experience or facts we like to make things dramatic and self important!

[Anonymous]

Anonymous wrote:OP here

Seems like some are missing the point. While in the ER I felt that I was in a used car dealership. That is. I felt the "team" was trying to push me into having their PA do the stitches because my insurance will pay them for that. Had a Plastic Surgeon come in, s/he would have been paid instead. It really felt like a business and that they were not focused on the best treatment. I would have paid out of pocket for plastics -- spoiled/ high maintenance/ whatever -- not the point. I feel the more important issue is that the hospital is so concerned about the money. A plastic surgeon will be called to r someone without insurance because better the surgeon gets stiffed than the hospital. So basically the hospital is refusing to give care because they will not be paid, however technically they are "not refusing care" because they will call in their free labor to do it. Yuck!!

This is not correct. The ER still gets paid for the ER visit, no matter who stitches up the wound. If the plastic surgeon had come in, you (or your insurer) would have received two bills, one from the hospital and one from the surgeon. It's no different from if you were having surgery at the hospital--there is a bill from the hospital and a separate bill from the surgeon.

The PA is not "free labor." The hospital pays his/her salary.

[Anonymous]

Anonymous wrote:

Anonymous wrote:CRNA here who previously worked in ER when I was an RN. PA's and MD's stitching skills are interchangeable. They both stitch just as frequently. A good care provider will know when a plastic surgeon needs to be called. If they said it wasn't necessary I would tend to agree. You are always allowed to leave and pursue a plastic surgeon yourself either by making an appointment or whatever avenues are available to you. However in my experience you can't call plastics too often (like unless its really needed) or else they will stop serving the ER all together because it is too time consuming.

sorry we have to ignore your first hand experience...here on DCUM we don't like experience or facts we like to make things dramatic and self important!

No way...only an MD has these skills...we can't possibly trust a "lesser" professional. OPs snowflake CANNOT be treated by a minion.

[Anonymous]

I don't really trust the urgent care facilities, fwiw. We took my child there once, and they "x-rayed" for a break. Only when I was signing out and reading the fine print did I notice a disclaimer saying it was not an actual x-ray, but something else (a c--ray, maybe?). We called an orthopedic surgeon after getting home and he said it was basically malpractice to not tell us that they were incapable of doing an x-ray, and that the machine they used would only be capable of detecting a break in a child's bones if the break were incredibly obvious. So we ended up spending 2 hours at the urgent care, then going back to the ER for another 3 hours.

[Anonymous]

Anonymous wrote:OP here

Seems like some are missing the point. While in the ER I felt that I was in a used car dealership. That is. I felt the "team" was trying to push me into having their PA do the stitches because my insurance will pay them for that. Had a Plastic Surgeon come in, s/he would have been paid instead. It really felt like a business and that they were not focused on the best treatment. I would have paid out of pocket for plastics -- spoiled/ high maintenance/ whatever -- not the point. I feel the more important issue is that the hospital is so concerned about the money. A plastic surgeon will be called to r someone without insurance because better the surgeon gets stiffed than the hospital. So basically the hospital is refusing to give care because they will not be paid, however technically they are "not refusing care" because they will call in their free labor to do it. Yuck!!

You've really jumped to a lot of conclusions here. As someone else pointed out, the PA is paid regardless. They don;t get paid a certain amount to do stitches and another certain amount because someone is dehydrated and needs an IV. Its not like they're paid per stitch. They are on salary. Calling in a plastic surgeon would have saved them the effort of doing it themselves and cost them nothing.

You are clearly very angry but its difficult for us to sympathize when you throw out these ridiculous accusations. Its difficult to judge the situation without knowing more about the cut. I do wonder, also, if you pulled the attitude with them thats reflected here.

[Anonymous]

Also, I don't believe doctors are paid to be on call. They are paid by the patients and mostly the insurer. The fact that this one ER has four plastic surgeons on call seems perfectly fine to me.

But you admit you were not behaving well. That could not have helped.