Guest Author - A. Maria Hester, M.D.
So you decide to take an early morning stroll through the mall, as you have done many times before. However, this time is different. You ate a spicy omelet for breakfast prior to hitting the walking trail and now you are paying for it. Twenty minutes into your walk you experience an uneasy feeling in your chest. Belching helps somewhat, but does not completely relieve the pain. Your old familiar indigestion is acting up again, so you try a ginger ale. After two strong burps, your pain completely goes away. However, your new work-out buddy insists that you go to the hospital to get checked out, and won't take no for an answer.
Reluctantly, you agree to her offer to drive you to the closest ER for further evaluation. On the way, the chest discomfort returns, so you take another sip of ginger ale, and again it subsides completely immediately upon burping.
The ED doctor is less than impressed. Your physical examination is unremarkable. Your chest X-ray is perfectly normal, and you give a strikingly good story for simple indigestion. You walk an average of 15 miles each week, never smoked, have excellent blood pressure and a surprisingly low cholesterol level. No one in your family every suffered from heart disease, except Aunt Beth who suffered a light heart attack and the age of 97.
The ER doctor is getting ready to write up your discharge papers when the tech hands him the last piece of the puzzle, your EKG. It doesn’t look too bad, but it is not perfect either. The physician ponders over whether to admit you for further testing, which he thinks will be unrevealing, or to discharge you home to follow up with your physician.
While he is 99.9% sure your chest pain is not due to a heart condition, that tiny blip on the EKG is enough to make him recommend that you be admitted to the hospital for further evaluation, just to be on the safe side. After all, he has no prior EKGs to compare the current one to and it is 10 pm on a Saturday night, so your doctor’s office is closed and he cannot get a prior EKG faxed over. Otherwise, he would have seen that that tiny blip has been there for years and that alone is no reason to admit you to the hospital.
In 2011, insurance companies mandate cost-efficient care. In this circumstance, they would likely be willing to pay only for observation status, not a true inpatient admission. While the testing and care are the same, the cost to the patient can be significantly higher.
Moral of the story. Try not to reinvent the wheel. If you have records at a particular hospital, try to return there for future visits so your physicians will have ready access to prior records.
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