Specialty service availability
Alright I specifically made this reddit account so I could vent about this (long time lurker in this sub) so bear with me.
The shop I work at is in the suburbs, so not my systems main university hospital where they have every specialist service under the sun but also not way out in a rural area. We specifically do not have OB/GYN, OMFS, peds, or optho. We never have and probably never will, been like that for years. Yet despite that, we routinely get 30+ week pregnant patients checking in, massive dental abscesses, major ocular complaints, etc. literally every day. Obviously I don’t blame patients for this, for the most part they don’t understand the difference and I get that an ER is an ER to most people, but it’s frustrating to spend hours playing phone tag with specialists at other hospitals, then hours on transferring people, just so they can sit in someone else’s ER to wait for optho or OB or whoever. Even EMS will do this sometimes, if our wait times look better or other facilities are on diversion they will end up with us.
Part of it is my own frustration but it sucks for patients too, obviously I have no issue seeing anyone for something emergent and most of the peds and OB complaints are pretty mild and easy to handle, but if it’s something legit they have to sit and wait to be transferred (which don’t even get me started on the inefficiencies there) and then usually sit and wait at the receiving facility as well. Sometimes just to be sent home!
I had this poor guy come in yesterday with an orbital cellulitis I needed to transfer to our main hospital and he was pissed that he had to wait on an ambo and didn’t understand why I couldn’t just admit him myself. When I explained it to him he hit me with a “well how the hell am I supposed to know your hospital doesn’t do eyes!” Which is a fair point, how would he know? He wasn’t super sick, and in hindsight I’m sure he would have gone directly to a hospital with at least the possibility of having optho on call, but how would he even know that? EMS at least has some protocols typically to give them a heads up what services are available where, but patients? Nothing.
Is there any resource out there I could have referred this guy to that would at least give him a heads up before he came in what services our hospital has? Just check the website? Same thing happens from PCP offices sometimes, I’ll get a call asking to send in some OB complaint and have to redirect them with a “we’re happy to see her but I would highly recommend she goes to X as they have 24hr OB call and she will be seen quicker if the pregnancy needs to be addressed”. Sick patients with EMS going to the closest facility I totally understand but sometimes they drop off OB or peds cases here because “everyone else is on diversion” or some other nonsense (not trying to shit on EMS, I was an EMT for years and it’s a tough job I get that).
Anyone have any thoughts, resources, or similar experiences? Rant over, thanks for coming to my TED talk.