What is the point of the ER?

goldennomad6 said:Unfortunately, you didn't actually read my post. You missed the point entirely. I was trying to highlight deep-seated systemic issues—stuff people outside of the medical field don't see, which is exactly why the whole system is broken.

I finally pulled myself out 😁 and I'm working privately now. You can't just call my cell and threaten me anymore. Now, you book an appointment, pay the fee, and we have a civilized conversation. I’m going to do what I love on my own terms. 🙂

Look, I know exactly how this entire machine works. I see it from the patient side—because unfortunately, I am one—and I see it from the healthcare provider side. I know the working conditions are a total disaster. There aren't enough nurses, not enough doctors, not enough meds... and patients? They're all over the map. Some lie, some exaggerate, some are just plain rude and aggressive.

But none of that justifies the real tragedies. It doesn't justify an ambulance not showing up, or someone dying while nobody takes responsibility. You didn't tell me what *you* would do in that situation, yet you attacked me for saying I'd want to beat some of these people senseless.

And if you had actually bothered to read my previous posts on this thread, you'd see I mentioned that I'd make sure everyone who calls 911 for nothing—every single hypochondriac who wastes a doctor's time with fake symptoms—gets billed for every single test, including the actual time the doctors and nurses spent dealing with their nonsense. Maybe then people would stop flooding the ER for every little thing just because they can't stand waiting two hours in a clinic line.

melloworca6 said:If you had actually taken the time to read my previous posts in this thread, you would have seen that I already stated that... If I had my way, I’d hold every single one of those people who fake an illness accountable. You know the type—the chronic hypochondriacs who flood the ER with nothing but imaginary symptoms. Once it turns out they’re perfectly fine, they should be on the hook for the bill. They shouldn't be allowed to waste a doctor's precious time or drain resources just because they have an overactive imagination. If you go looking for a crisis that isn't there, you should be the one footing the bill for all those unnecessary tests and scans. It’s a matter of fairness, really. Think about all the wasted hours—the sheer amount of time doctors and nurses lose just dealing with people's nonsense. If you actually accounted for that lost productivity, you’d see how quickly enough funds could be scraped together to... How on earth do we get people to stop treating the ER like a walk-in clinic just because they can't be bothered to wait two hours for an appointment with their regular doctor? It’s become such a massive issue lately. Every little thing—a scratch, a mild sniffle, something that could easily wait until Monday—ends up in the emergency room because people simply don't have the patience to deal with the actual medical system. It’s like when you see a line out the door at a high-end steakhouse in Manhattan; if you aren't willing to wait for a table, you go to a fast-food joint, but the ER isn't a burger stand. It’s meant for crises. When everyone rushes there just to skip the queue at a primary care office, the whole system starts to buckle under the weight of non-emergencies. We need a way to redirect that flow before the actual emergencies get buried under a mountain of trivial cases..

I’m signing this! Count me in!🙏

It honestly drives me up the wall when I’m over on Cleveland Avenue. You see these people—complete idiots, really—who rush their kids straight into the ER just because they have a tiny fever or a little cough. It’s infuriating. Then there’s someone like me, showing up with a child who picked up a nasty bacterial eye infection at daycare. It’s progressing so fast that his eyes are practically swollen shut and oozing, yet I’m stuck sitting there for two hours because of those people.
I honestly don't get why they don't just send those kids back home... or at least pass them along to their own pediatrician. I mean, surely they have enough sense to distinguish between an actual emergency and something that can wait, right?🙄

Because they aren't allowed to. If heaven forbid something actually happened to a kid after they sent them home, they’d be the ones held responsible.

Amanda Ross10 said:I am right there with you!!!!🙏

It drives me absolutely insane when I’m at the Cleveland clinic, and because some idiot decides to drag their kid in for a tiny little fever or a sniffle, they get rushed straight to the ER. Then I show up with my kid—who caught this nasty eye infection at daycare that’s progressing so fast his eyes are actually swollen shut and leaking pus everywhere—and I’m stuck waiting for two hours just because of those morons.
I honestly don't get why they don't just send people like that home... or pass them off to a regular pediatrician. I mean, surely they can tell the difference between an actual emergency and something that isn't.🙄

Look, yeah, there are people who run to the ER for nothing, but you can't call a parent an idiot just because their kid has what seems like a "standard" fever. You never know—that temperature that looks "normal" to one person could be way more dangerous than a simple eye infection, and who’s to say which one should be the priority? Every single parent with a sick kid thinks theirs is the most critical case, so they want immediate attention. Being sick is being sick, whether it's a high fever, an eye thing, a sore throat, or a runny nose. It's only a true emergency when someone can't breathe or is genuinely crashing.

melloworca6 said:Seriously, try reading my entire post before you decide to cherry-pick the one sentence that fits your narrative. 🙄 I never said anyone should storm an ER and start throwing punches. People are saying they called 911, no one showed up, and someone they love died because of it.

Look, sorry, but if my kid, my mom, my dad, my spouse, or my sibling died just because someone decided not to do their job, yeah, I’d probably crack some skulls too. Since our legal system is basically non-existent, isn't a little bit of fear the only way to actually get people to care about their own lives?

How many people have to die at the hands of certain individuals before we finally swap them out for someone competent?

And tell me, would you really be sitting there all calm and collected if your child died because some medic couldn't be bothered to send an ambulance for an hour?

Signed.
When I talked about dropping down to Neanderthal levels, I was strictly referring to the specific situation I described.
Let's be crystal clear: I'd act exactly the same way if the life of someone I love was on the line and the paramedics were busy messing around. In a moment like that, all social etiquette flies out the window and I turn into a beast fighting for my family's survival. And honestly, I'd love to see anyone try to mess with me then.

I'm not talking about showing up at the ER with a slight fever. 🤦

Vehicle count is irrelevant. It’s the number of crews that matters, and we’re always understaffed.
Having just two teams for 150,000 people covering 60 square miles is a joke by any standard.
It’s like saying a tiny fishing village is overstaffed because they have six teams instead of one during the summer season.

A hospital ER and an ambulance service are two different entities.
Both run on 12-hour shifts.
And you almost never see them getting a full hour for lunch or a breather after a heavy call. Why? Because some sensitive soul might have a meltdown if they see staff sitting there reading the news or grabbing a bite while their loved ones are in agony.
People lose their minds on both sides, often for good reason, but sometimes just because.

The drivers are just drivers instead of being trained medical technicians.
Most of them—drivers and the public alike—think the priority is tearing up the streets before or after a patient drop-off. They think the job is just tossing someone in the back and speeding off.

Non-emergency transport drains resources fast. A lot of people treat it like a glorified taxi service.
In both transport and EMS, another massive headache is dealing with patients who are way over the weight limit for the rigs.

It’s on the patient to show up at a clinic or dial 911 for something trivial.
And it’s on the doctor to decide whether to admit them or send an ambulance.

The whole system is idiotic—writing reports in one office, picking up prescriptions in another, and grabbing meds in a third.

It’s not a magic fix, but cities and counties (since the federal government is a mess anyway) can set aside extra funds to actually improve emergency services.

Something decent is actually in the works: regional hubs.
A centralized dispatcher who can send units anywhere in the county, regardless of specific territory lines.
For now, the "city" crews and the "suburban" crews will probably play hide-and-seek with each other, but the number of vehicles and teams stays the same.

The real solution is more crews, better equipment, constant training/certifications, GPS tracking... who knows what else.

Until then, enjoy yourselves while you can. Stay healthy.
Don't count on the ER too much.
Some guys are total jerks, and others are just doing the best they can with the scraps they've been given.

You could have ten ambulances parked right outside the ER, but what’s the point if you've only got one single crew on duty? Like, just one doctor per shift. Seriously, they should just hop in those extra vehicles and actually go out there to save lives across the city.
The reality is, an ambulance can't be in ten places at once. When you call 911 and start losing your mind because they didn't show up within fifteen minutes, maybe just take a second to think. Maybe they were fifty miles away fighting to save someone's life. Or maybe they had to deal with someone having some super minor issue who just refused to drive themselves to the hospital and instead threatened to call the news or sue.

Look, it’s obvious to me that if you only have one ambulance, that vehicle can't be in ten different places at once.

But what about those situations where you drive someone to the ER yourself, only to have them practically brush you off? What's the excuse there?

Take my friend's mom, for example. She felt off all afternoon, then started vomiting in the evening. She couldn't even stand up—just terrible dizzy spells—so they drove her to the emergency room. Once she got there, the staff just pumped her full of sedatives and sent her straight home without doing a single actual exam. Of course, that cocktail of drugs knocked her out for the whole night, and by morning, when it wore off, she felt ten times worse. They rushed her back to the hospital, only to find out she'd actually had a stroke yesterday before she even showed up. If they hadn't just drugged her and actually looked at her, maybe they would have caught it.

So, what do you do when things like this happen? Do you just let it go like my friend's family did, even though her mom is dealing with health consequences today because of it? Or do you sue? Or do you take matters into your own hands and kill God in someone?

I called 911 last week.
They didn't waste my time with useless questions. They just needed to know what happened, the patient's age, and her medical history.
The paramedics arrived incredibly fast, and the whole crew was actually polite, which I appreciated.
Sadly, it was too late for my mom. She just drifted off, and her heart stopped... she was 83.
I have zero complaints about them—from the initial call to their arrival (about 10 minutes) through to when they left. They were kind and genuinely sympathetic.
In my opinion, the biggest issue with our healthcare system is poor organization and cutting corners on how many crews cover an area... honestly, anyone calling emergency services for something stupid should probably be billed for the stupidity.

nimblesurfer30! Spot on, concise and accurate. I’m with you on this one.

People really ought to understand that emergency services aren't meant to deal with every little issue a primary care physician could easily handle. Unfortunately, that seems to be what most of our calls end up being. The vast majority, actually.

I suppose I can share a few more insider stories.
The major metropolitan units, like the ones here in New York City, stay pretty well-staffed, but all the rural counties are absolutely struggling to find personnel (even though the pay for EMS is actually quite good!). It’s mostly just very young doctors, usually fresh out of residency or their initial training. It’s a shame, really, because this is exactly the kind of work where experience is everything—I remember them saying that learning to distinguish what’s critical from what isn't is one of the most valuable skills you can have. This job burns you out. Between the shifts and the double shifts—sometimes running 17 or 24 hours straight—it takes a toll. And while some of the rural crews spend most of their time just sitting around, those of us in the city center don't exactly get a break. Take our unit in New York City, for instance; we might only head back to the station on Heinzelov once or twice, but the rest of the time we're just circling the city because you finish one call and immediately get dispatched to the next. You barely even have time for lunch.
Emergency response is categorized into levels—which is why, unlike in some other countries such as Belgium, we don't have sirens and lights blaring constantly for every single call—and we don't respond to every level with the same level of urgency. A car accident or an injured child on the road will ALWAYS take precedence over anything else. That’s actually what causes delays most of the time; your call is received, the ambulance is en route, but then they get diverted to something more critical... although people haven't really complained to us about waiting too long; if anything, they seem surprised at how fast we arrive, since we're often redirected from a nearby unit rather than coming straight from dispatch.
On average—at least for my crew—we’d handle about ten interventions per shift. Out of those ten... maybe seven or eight could easily be handled by a family doctor, or frankly, don't even require an ambulance. For example: a 75-year-old woman who called because her blood pressure was 160/100 that morning (but by the time we arrived, it had dropped back to her usual 140/90), women dealing with "stuck" issues that still allow them to walk around, fevers, headaches, or drunk people. There are kids hoping to land their parents in the hospital, and elderly folks who pass out and are met right at the gate because their children, who called it in, couldn't be bothered to wait. Or that 80-year-old lady who hadn't had a bowel movement in three days (yes, they called 911! yes, we showed up! yes, the doctor spent way too long lecturing her about the benefits of yogurt, grapefruit, and prunes...), and then there are countless young women dealing with various romantic drama... ugh, it's a lot.
There was this one time in real life, we were transporting a patient to the hospital when the dispatcher calls in asking who's free, telling us to hurry because there are three accidents and they urgently need an ambulance (hm...).
Could it be better? Yes, it could! It has to be! They are finally introducing specialized emergency medicine certifications now, which I hope will help. Also, the EMS system needs to take on more responsibilities so we aren't just driving around constantly, but it’s still hard to avoid those cases mentioned above, because people somehow think that if they aren't happy with their GP or their appointment time at the hospital, they can just call 911.
And I also agree that there are certainly idiots doing this job, but first, you have to realize how sad it is that the system even allows it... it's a difficult profession.

It’s actually pretty easy to catch them red-handed just by auditing the bills. Honestly, for these kinds of stupid, trivial things—like if someone didn't have a chair for three days 🙄—I’d be all for handing out fines. You'd see order established overnight if people knew they couldn't just call 911 for every little nonsense moment.

Look, in a massive metropolis like New York City, you really ought to have teams and vehicles distributed across different neighborhoods. They should have parking for rigs on municipal land so every district has at least one or two units instead of everyone being clustered together on Heinzelov. Based on how long we were waiting for the old crew, I’m guessing they all started from downtown, which is just a joke. What if, for example, they were stationed in the Highlands near me, say in the Grižanska area—they could reach the most remote corner of the neighborhood in 10 to 15 minutes! Absolutely. Then you just rush the patient to the nearest hospital, and you could actually save lives. Or, if someone gets sick in an apartment, like in some student housing, the call comes in and either a different crew is dispatched or the unit already out on a call handles it. From my amateur perspective, if the absolute priority is traffic accidents, then this whole system is garbage because people exaggerate their stories just to get an ambulance to show up, only to end up with two minor injuries. The most critical emergencies are heart attacks and strokes; everything else is secondary, but I doubt a GP is going to know the difference, nor will the ones giving them orders.

melloworca6 said:It’s because they aren’t allowed to. If heaven forbid something happens to a child after they've sent them home, the liability would fall squarely on their shoulders.

Look, I get that there are legal restrictions, but surely they could at least give parents a firm warning? It's like teaching a kid a lesson; if you tell someone a few times that they shouldn't do something, eventually the message should sink in.
Or better yet, they should triage the kids based on urgency. Let those folks who think everything is an emergency wait in line for four or five hours like everyone else—maybe then they'll realize that not every scraped knee requires an immediate trip to the ER.

Robin Gray8 said:Look, there are certainly people who rush to the ER for absolutely trivial reasons, but when a parent brings in a sick child with what seems like a "standard" fever, they aren't necessarily being fools. There are instances where a temperature—even one that looks routine to an outsider—can lead to much more serious consequences than, say, a simple eye infection. Why would an eye issue take priority over a fever? Every parent with a sick kid feels like their situation is the most urgent, and honestly, sickness is sickness. Whether it’s a high fever, an inflamed eye, a sore throat, or a stuffy nose... true emergencies are when someone can't breathe or is genuinely crashing.

If the temperature is under 100 degrees and you haven't even attempted to bring it down yourself by giving them a lukewarm bath or some Tylenol, then you have no business heading to the ER. Besides, pediatricians on call at local clinics handle these things just fine, unless we're talking about an infant under three months old or a child who has experienced febrile seizures.
I think you're missing my point entirely. I am specifically talking about those types of people; please don't strip the context away from me. What exactly is the expectation here? Should every single parent see a reading of 102 on the thermometer and immediately sprint to the emergency room without trying to manage it at home first? It happens constantly, and frankly, it's tragic that nobody seems able to put a stop to it.
I work in the medical field, so I know exactly what I'm talking about. I only used the eye infection as an example this time... it was totally irrelevant to the main point, and actually, we had priority over them because the infection was purulent—meaning it was likely bacterial, staph, which is contagious... you follow me?! (And yes, the swab confirmed it was staph...)
There were children being examined who ended up leaving without any medication at all... simply because they didn't need any. Their issues were just a sore throat, a common cold, or a minor virus—nothing serious. Naturally, they were just referred back to their regular pediatrician.

[QUOTE=Amanda Ross10;3

Seriously, don't let it get to you. 🙂

Look, I drive for a living, so I get it—I know it’s not always about the non-emergencies and I know they really do try their best to reach patients. I remember on New Year's Eve when we called and they told us there was a massive pile-up on the interstate bypass, so they had to divert a ton of ambulances over there. But listen, when we called 911 and told them a man had stopped breathing and we were performing CPR—meaning this guy is literally dying, this isn't some joke, it's a life-or-death situation—all they did was bombard us with a bunch of stupid questions. Instead of giving actual medical guidance, they didn't even arrive any faster; in fact, it took forever... and we had to call them twice. The second time was 15 minutes later, which was already too late, but you just keep hoping 😢
Honestly, what they told us was just as bad—that they could have been here in five minutes but the chances of doing anything useful would have been incredibly slim. That is just gut-wrenching. It makes me feel like everyone needs to have a first aid kit at home stocked with adrenaline shots and glucose tabs
And it is absolutely horrific that after someone passes away at home, you have to call the police just to wait for a coroner who won't show up until the next day because there is only one (1)??? coroner for the entire city of New York. So, basically, someone dies, you go through a massive trauma, and then you're stuck sitting there with the body for over 12 hours... I don't know, but it looks to me like there are some seriously dangerous gaps in the entire system

Jessica Hall95 said:.....I don't know, but I can see some things aren't quite clicking within the whole system

And honestly, that right there is the heart of the issue.
It isn't about a shortage of ambulances (!) or medical crews.

The system just doesn't work—just like most government systems in this miserable country. ☕

I feel like I really ought to share a positive experience here. A few days ago, things just went south fast—within about ten days, I had several bouts where I felt absolutely terrible. Nothing seemed to help, everything just kept getting worse, and I honestly thought maybe the devil himself had decided to play a cruel joke on me. I eventually hopped in my car, drove straight to the ER, and knocked on their door. They all swarmed to help me immediately. It was a weekend, and well past ten at night. Now, I realize my story isn't exactly the norm, but I was just so pleasantly surprised by how kind and professional everyone was, from the doctors down to the nurses. They kept running various tests on me until, within just a couple of hours, we had covered pretty much everything possible in that moment. That included having blood drawn while lying down, since I’m a little 🙄 when it comes to needles—which I did mention—so the nurse actually led me over to a couch, drew my blood, cracked a window for some air, and just gave me whatever time I needed to pull myself together. I truly believe the quality of care depends so much on the people on the other side of the desk and just how heavy their day has been. Maybe I just got lucky because there weren't many other patients around when I arrived. Or maybe I just looked like a total wreck (my blood pressure was through the roof, and my pulse was sky-high); or perhaps it was just that I wasn't expecting nearly as much as I got.
Mostly, though, I'm trying to see things from the other perspective. Like others have mentioned, and as a couple of my friends who work in hospitals and ER departments tell me, not everyone is the same, and sometimes people show up without any real reason at all.
As for the paramedics who respond to calls out in the field, I sincerely hope I never have to rely on them. From what I understand, it's always better to call them because then the patient goes directly into treatment, whereas if you drive yourself, it isn't quite as seamless. I know of some tragic stories in New York City where young people passed away because it took the ambulance far too long to reach them.
I wonder why they don't establish some kind of traffic control for those kinds of emergencies. When new highways are being built, why isn't there always a dedicated center lane specifically for emergency vehicles? When I look at the traffic in New York City, constantly stuck in gridlock with cars honking incessantly, I really have to hand it to those drivers who manage to weave through the streets to get where they need to go.

Christian White3 said:I suppose in a massive metropolis like New York City, you’d expect teams and vehicles to be distributed strategically across different boroughs, perhaps having their own dedicated municipal parking lots so each unit could station one or two teams locally...

But honestly, the paramedics are rarely just sitting around on Heinzelov; once they head out on a call, they don't really circle back to base, they just keep patrolling the city. I mean, unless it's lunch, though obviously they don't all break at once. New York City is huge, sure, but with sirens blaring, you can get pretty much anywhere fairly quickly. This setup isn't actually as bad as people make it out to be, I guess.

Christian White3 said:From my amateur perspective, if the main priority is emergency traffic response, then this whole system is a mess because people tend to exaggerate their symptoms just to get an ambulance to show up, when in reality it might just be two minor injuries. The most critical situations are heart attacks and strokes, whereas everything else is secondary, but I suppose a general practitioner wouldn't necessarily know how to distinguish them, nor would the people overseeing them.

Oh boy, there's no need to get so worked up. I think your premise is fundamentally flawed, because the truth is that people more often fake heart attacks and strokes than accidents. Most people wouldn't even recognize the warning signs of a heart attack or a stroke until it's far too late—specifically when talking about strokes. Diagnosing a cardiac event or a stroke isn't exactly some simple task, either.

And by the way, you really ought to trust your primary care physician, because if you don't, they won't be of any help to you at all; you're probably better off just finding a new doctor. In certain countries, people spend almost their entire lives relying solely on primary care, and frankly, if a doctor in those places refers you to a hospital, it's usually a sign that things are going poorly.
In my personal opinion, the healthcare crisis here in America is inextricably linked to the crisis within primary care. That system needs to be overhauled so that primary doctors can once again become the central pillar of the entire medical infrastructure.

Terry Martinez55 said:Honestly, you rarely see them parked over on Heinzelov. Once those crews head out to a job site, they don't just head back—they end up circling around town all day. The only exception is lunch, but even then, they never all break at once. New York City is relatively small once you get used to it—it’s basically all under one big umbrella, and you can get anywhere pretty easily. The way they've organized things here isn't half bad.

I learned the hard way on the night of September 12th, 2010, when my old man passed away. The paramedics were crawling down the street like they were heading to a wedding or something. I guess we must have interrupted their poker game or their beer break, because they seemed more interested in taking their sweet time than actually helping. They didn't even bother bringing a defibrillator into the house—it was obvious they knew that every minute they delayed, his chances of survival dropped. Once you describe the symptoms, the diagnosis is clear: he was in shock from coronary artery blockage. In a case like that, the only hope is getting immediate, lightning-fast intervention. There were no injuries, no bleeding; it was textbook cardiogenic shock. But those little general practitioners working the ER barely seem to know what that even means. Honestly, an EMS service like that is completely useless; you might as well just shut it down. ☕

Look, there's no need to get worked up. First off, you're looking at this from the wrong angle. The reality is that most people fake symptoms of heart attacks or strokes when they’re actually just having accidents. Most folks wouldn't even know how to spot the warning signs of a stroke or a cardiac event until it’s far too late—that's usually the only time they realize something is actually wrong. Diagnosing a stroke or a heart attack isn't some simple, trivial task either.

It’s not your job to play psychologist and figure out if someone is faking it or not. If someone calls you in the middle of the night panicking because their parent is struggling—if they’re slurring their words, gasping for air, or breaking out in a cold sweat—you don't sit there overanalyzing the situation. You just show up. If you can't handle that, or if you’d rather stay behind playing cards with your buddies than answer a call, then honestly, find another career before you cause more harm. ER departments are meant to be staffed by people who actually care about saving lives—cardiologists, neurologists, surgeons—not by people acting like veterinarians.

Look, you really have to trust your primary care physician. If you don't have that level of confidence in them, they aren't going to be any help to you at all. Honestly, if that's the case, you’re better off just finding a new doctor. In some countries, people spend their entire lives relying solely on primary care. In those places, if your doctor actually refers you to a hospital, it's usually a bad sign.
In my personal opinion, the healthcare crisis in America is directly tied to the breakdown of primary care. We need to scrap the current system entirely. It's time to bring back family doctors and make them the central backbone of our entire medical infrastructure again.

What's even the point of having a primary care physician or a GP? They’re lazy, undertrained, and honestly, they act like you're a massive inconvenience just because you showed up to pick up a prescription or a referral for yourself or your family. All this "e-prescription" and "e-referral" nonsense was only introduced so they could finally get rid of the crowds in the waiting room. It's a way to stop patients from getting on their nerves, because clearly, they don't care about anything other than their own comfort. It doesn't bother them one bit that they can show up at 8:30 instead of the scheduled 7:30, head home before 1:00 PM, and take hour-long breaks, even though the official hours at my local clinic are 7–2 and 2–9 with only a thirty-minute break. I'd switch to another doctor, but there isn't anyone else in my area. 6.2 miles I don't have any other clinic to go to

And in the end: if I had only known they were going to take forever: I would’ve just hopped in the car, dragged him out to the vehicle, and been at the Highland hospital in five minutes because I drive like a maniac. Maybe I’d still be alive today. I'm just going to keep blaming myself for not doing more for him, who knows how much longer I'll feel this way.