Another EM Rotation Done

I finished up another rotation in emergency medicine. This time I worked at a large government hospital where no one has to pay for any care. It was an extremely frustrating experience to say the least. There was so much "red tape" and "hoops" to jump through that it was nearly impossible to practice good medicine. The supplies and equipment were sub par and non existent. The excuse was always "we do not have the funding". The technology and equipment that was there was outdated and not comparable to any modern hospital. The employees complete lack of desire and motivation to do any work made treating patients difficult. Emergency medicine is certainly a team sport and when a large portion of the team does not care enough to put any effort in, you can imagine how inefficient the process becomes.

I am glad that I did my rotation here because it confirmed that this is not the kind of program that I would want to train at for residency. The average wait for patients to be seen by a doctor was often more than 18 hours. Once the patient was seen by the doctor it seemed that the entire goal was to do the least amount of work possible and then get the patient out of the ED to be someone else's problem. Then the patient was shuffled around by the other services in the hospital. It was truly unbelievable. I think anyone who is a proponent of socialized medicine in America should come and witness the disaster that is called medical care at government hospitals. Even when the doctors at these hospitals are top notch as many of them are, they are handicapped by the ancillary services that are inefficient or even worthless.

For example we had a patient that we needed to get a test done immediately so that we could make the correct diagnosis and start the proper treatment. Without the test we could not begin treatment or it would be dangerous for the patient. I make the call to the department that handles the test and I explained that we needed the test ASAP. They responded that they were on a mandatory break and could not perform the test at that time. I begged and further pleaded my case only to be hung up on. Ultimately this case turned out ok because I was able to work around the given test but it certainly delayed treatment. This kind of scenario is a daily frustration and many times the end results are not favorable.

Also this hospital is hemorrhaging money and continuing to use up tax dollars to provide subpar services. The medical system is in need of fixing but the idea that the government can somehow run it seems unlikely given my many experiences working at multiple government hospitals. I certainly do not claim to have the perfect solution but I think the solution should not include anything that resembles the VA and County hospitals that are scattered throughout the USA. The patients do not pay with money but they do pay and it can be far more costly than any amount of money.