Patient Dies After Being Turned Away For Being 10 Minutes Late

[+ Avalon]

http://www.newsweek.com/5-year-old-girl-dies-asthma-doctor-refused-service-10-minutes-late-health-care-822485

 

 

Many years ago when I was at my doctor's office an adult male was turned away because he did not have his co-payment.

 

I don't know whether it was my doctor or not, he belonged to a group. It was the receptionist refusing the man.

[+ sync]

A very dark relief is knowing that the deterioration of medical ethics is not peculiar to the U.S.

[rvwnsd]

The part that got me was that by the time she got to the front of the line she was ten minutes late. Not faulting the doc for having a line, but if that's the reason the patient is late she should see the patient.

[RM]

This could never happen at my Mom's doctor's office. Patients wait at least an hour every time. He schedules patients 15 minutes apart and sees each one for at least 20 minutes. I don't know about the UK, but I can't imagine a jury here awarding less than several million $.

Edited March 1, 2018 by RM

[caliguy]

Anyone ever hear of priority status? This was known since field medics were a thing.

[gallahadesquire]

Anyone ever hear of priority status? This was known since field medics were a thing.

 

It's called triage.

 

tri·age

/trēˈäZH/

noun

noun: triage

1. (in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.
   
   • the process of determining the most important people or things from amongst a large number that require attention.
     

verb

verb: triage; 3rd person present: triages; past tense: triaged; past participle: triaged; gerund or present participle: triaging

1. assign degrees of urgency to (wounded or ill patients).
   

[escortrod]

This could never happen at my Mom's doctor's office. Patients wait at least an hour every time. He schedules patients 15 minutes apart and sees each one for at least 20 minutes. I don't know about the UK, but I can't imagine a jury here awarding less than several million $.

The UK doesn't have punitive damages in tort cases, and almost all tort cases are decided by a judge (with the exception of some privacy cases). It is very unlikely that a civil case will be brought against the doctor. Had the child survived but suffered significant injuries that required care then a civil case against the NHS may have been brought by the parents, but the damages would have been limited to 'actual' damages, i.e. the financial cost of additional care for the child.

 

It is likely that there will be an investigation by the General Medical Council into the doctor's actions, with the possibility of the doctor being barred from practice.

[escortrod]

It's called triage.

 

tri·age

/trēˈäZH/

noun

noun: triage

1. (in medical use) the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.
   
   • the process of determining the most important people or things from amongst a large number that require attention.
     

verb

verb: triage; 3rd person present: triages; past tense: triaged; past participle: triaged; gerund or present participle: triaging

1. assign degrees of urgency to (wounded or ill patients).
   

Which, at least in the UK, is something carried out in Accident and Emergency (ER), not doctors' surgeries.

[+ Funguy]

I know of clinics where, if the patient is even 5 minutes late, they are turned away. BUT, at each one, vital signs are taken if the child is in an "emergent situation," and if abnormal they are put in a room to be seen - maybe 20 minutes or maybe an hour depending on how sick the child is. If vital signs are normal they are referred to Urgent Care or given an appt for the next day.

 

I have always objected - 5 or 10 minutes late is nothing. An hour late is something else. I have also always pointed out to the Clinic Directors that, if they take vital signs, it is tantamount to accepting that patient for that visit.

[+ FreshFluff]

The part that got me was that by the time she got to the front of the line she was ten minutes late. Not faulting the doc for having a line, but if that's the reason the patient is late she should see the patient.

 

Yes, I noticed that too. It's really sad that working-class people have to put up with this crap.

[OCClient]

Sad how maximizing the revenue stream became the one objective.

Decisions about health at my prior clinic (HealthPartners) seem to come from a checklist the doctor reviewed on a screen.

 

Waiting times at my new clinic (Hoag) are excessive. Patients stuck in the sprawling waiting area become upset, but what can be done? <-- That's a rhetorical question.

[escortrod]

Sad how maximizing the revenue stream became the one objective.

Decisions about health at my prior clinic (HealthPartners) seem to come from a checklist the doctor reviewed on a screen.

 

Waiting times at my new clinic (Hoag) are excessive. Patients stuck in the sprawling waiting area become upset, but what can be done? <-- That's a rhetorical question.

This is an NHS doctor, so it has little to do with the revenue stream. Rather there are a large number of latecomers and missed appointments which substantially reduce the efficiency of a system already stretched to breaking point. Some doctors are enforcing appointment times for that reason.

[+ nycman]

A byproduct of the fact that socialized medicine lacks any incentives to provide efficient and timely care.

 

If you treat physicians like assembly line workers....they will behave like assembly line workers.....

 

"My shifts up....time to go home....sorry about your dying child...maybe the next drone can help you....I'm finished here"

 

And thanks to government run socialized medicine I'd bet their options for suing are extremely limited to non-existent.

 

You can't sue the King.

 

No system is perfect.....but be careful what you wish for people!

[coriolis888]

http://www.newsweek.com/5-year-old-girl-dies-asthma-doctor-refused-service-10-minutes-late-health-care-822485

 

 

Many years ago when I was at my doctor's office an adult male was turned away because he did not have his co-payment.

 

I don't know whether it was my doctor or not, he belonged to a group. It was the receptionist refusing the man.

 

 

In the U.S. that behavior (turning away a patient for being a few minutes late for an appointment) is classified as a medical error even though the patient was not seen by the doctor.

 

How about the below cited article for the THIRD LEADING CAUSE OF DEATH IN THE U.S.

 

https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html

[escortrod]

A byproduct of the fact that socialized medicine lacks any incentives to provide efficient and timely care.

 

If you treat physicians like assembly line workers....they will behave like assembly line workers.....

 

"My shifts up....time to go home....sorry about your dying child...maybe the next drone can help you....I'm finished here"

 

And thanks to government run socialized medicine I'd bet their options for suing are extremely limited to non-existent.

 

You can't sue the King.

 

No system is perfect.....but be careful what you wish for people!

An inherent benefit of the NHS is that because it is free at the point of access, patients do not put off doctors visits for fear of cost and therefore do receive timely care. The UK spends half per capita what the US spends on healthcare, yet has similar outcomes, so the NHS could reasonably be called 'efficient'. According to the World Health Organisation fewer than 1% of patients in the UK avoid doctors visits because of concerns about costs. Compare that to the US:

 

"

Challenges affording care also result in some Americans saying they have delayed or skipped care due to costs in the past year, including 27 percent who say they have put off or postponed getting health care they needed, 23 percent who say they have skipped a recommended medical test or treatment, and 21 percent who say they have not filled a prescription for a medicine.

"

https://www.kff.org/health-costs/poll-finding/data-note-americans-challenges-with-health-care-costs/

 

I know plenty of doctors in the UK, mostly from my time at university, and they rarely finish their shifts on time. If you have any evidence that doctors in the UK act any differently with regard to their legal or ethical responsibilities towards their patients I would be fascinated to read it.

 

It is perfectly feasible to sue an individual doctor or the NHS in the UK. Tort laws in the UK are different to the US, however, and available damages are substantially lower, since punitive damages are not available. That is not restricted to medical malpractice, nor does it only apply when suing a state entity. Added to that it is often less necessary to sue in the first place, since socialised medicine and welfare means that actual costs flowing from medical malpractice are lower than in the US. Given how poor your 'bet' would be about options for suing being limited because the NHS is a state run organisation I hope you aren't a gambling man.

[+ saminseattle]

I was just reading an interesting article about all this the other day. It’s a bit long, but well worth the read. https://www.medscape.com/viewarticle/892210?nlid=120671_3521&src=WNL_mdplsfeat_180213_mscpedit_radi&uac=73321SK&spon=35&impID=1558470&faf=1#vp_1

 

One line stands out to me: “The British public can't have it both ways. They can't simultaneously enjoy the thrift of a healthcare system with a tab of only 9% of the GDP, yet demand a structure needed to catch outliers. Such a structure costs…. If the British public insists on thrift, they must also accept the errors that come with thrift.”

 

The same thing applies to queues, fixed appointment times, the recent strikes by junior doctors, etc. It’s the same old story, and one that applies to the US healthcare system as well: people want more than they’re willing to pay for, but in the end, something has to give. My impression is that the NHS these day is, as @escortrod said, “a system already stretched to breaking point.”

[escortrod]

I was just reading an interesting article about all this the other day. It’s a bit long, but well worth the read. https://www.medscape.com/viewarticle/892210?nlid=120671_3521&src=WNL_mdplsfeat_180213_mscpedit_radi&uac=73321SK&spon=35&impID=1558470&faf=1#vp_1

 

One line stands out to me: “The British public can't have it both ways. They can't simultaneously enjoy the thrift of a healthcare system with a tab of only 9% of the GDP, yet demand a structure needed to catch outliers. Such a structure costs…. If the British public insists on thrift, they must also accept the errors that come with thrift.”

 

The same thing applies to queues, fixed appointment times, the recent strikes by junior doctors, etc. It’s the same old story, and one that applies to the US healthcare system as well: people want more than they’re willing to pay for, but in the end, something has to give. My impression is that the NHS these day is, as @escortrod said, “a system already stretched to breaking point.”

It absolutely is. I am under the impression that the majority of the British public are willing to pay more for the NHS, but the Tories are more minded to privatise as much as possible to take the costs of the NHS off of the country's balance sheet. Hopefully Labour will offer credible opposition by the next general election, so we can start investing in our healthcare system properly again.

[Guest]

In our office, we will see patients up to 15 minutes late. But any patient turned down will be seen by a nurse, and there will be some evaluation if the patient is ill, to determine that the patient is safe to leave the office. When I do see late patients, I give them the option of either rescheduling or to be seen at the end of the clinic, after I see all of the patients who are on time first. I have little control over the lateness of some of my clinics (due to my not being in control of my scheduling, and due to patients coming in who often have time-consuming needs), but one thing I can control in terms of keeping my clinic as on-time as possible is when I see late patients. I see no reason to make patients who are on time suffer because of a late patient's lack of consideration for others.

[mike carey]

While I can understand 'culling' patients who turn up late as a method of keeping the day on schedule, I have some difficulty with the idea of doing so when the doctor is behind schedule. A sort of 'you have to be on time but I can be as late as I need to be' attitude. I would have thought you should be able to keep your place in the line until the time at which the doctor would have seen you on that day. You could be lucky, as it were, if you were an hour late and the doctor was an hour and five minutes behind schedule, you could be unlucky and be five minutes late on a day when the doctor was on time (although 5 to 15 minutes grace would be appropriate).

[Guest]

While I can understand 'culling' patients who turn up late as a method of keeping the day on schedule, I have some difficulty with the idea of doing so when the doctor is behind schedule. A sort of 'you have to be on time but I can be as late as I need to be' attitude. I would have thought you should be able to keep your place in the line until the time at which the doctor would have seen you on that day. You could be lucky, as it were, if you were an hour late and the doctor was an hour and five minutes behind schedule, you could be unlucky and be five minutes late on a day when the doctor was on time (although 5 to 15 minutes grace would be appropriate).

Well, the problem with late patients is they are most often the early patients (i.e. 8 AM) who just don't want to get up early. Then I arrive at the clinic with nothing to do until the next patient shows up. If patients take the attitude, "Well, the last time I was there, I was seen 20 minutes late, so I should show up 20 minutes late, and then I won't have to wait...", this puts the clinic schedule in complete bedlam. It's disrespectful not just to me and my staff, but to other patients, and the family members who may be accompanying them as well. Almost all of the time, when I'm late, it's due to circumstances beyond my control. I'm not sitting around playing video games. If I fly American Airlines, and their flight takes off half an hour late, this does not give me the right to check in late for my next flight. If I tried to do that, I would expect the airline to tell me tough luck. Just as with the airline industry, with medicine, unpredictability is unfortunately the rule (probably even more so than the airline industry). When I go to the airport or to my doctor's office, I allow for this and take a book or magazine to read. I don't expect everybody else to wait for me because of my tardiness.