I’ve been ranting recently about physicians recommending visits to the ER partly/mainly/largely to mitigate the risk of being sued instead of basing recommendations entirely on medical grounds. That costs patients and caregivers time (often a lot) and money, slows treatment for real emergencies, and makes health insurance more expensive by driving up costs to the system.
Does this phenomenon also represent a threat to public health? From yesterday’s Boston Globe (Intestinal germ leaves trail of misery)
More than 3,700 patients stricken with nausea, vomiting, and diarrhea have visited Boston’s emergency rooms during the past six weeks in a wave of gastrointestinal illness… “We have seen a large number of cases of what appears to be a sudden onset and intense, short-lived diarrhea, nausea, and some abdominal pain,” said Dr. Jonathan Olshaker , Boston Medical’s emergency department chief.
[N]orovirus, an intestinal germ that travels easily from person to person.
The article says public health officials can’t quite figure out why it is spreading.
My first concern (attention commenters, get ready to pounce!) is why so many norovirus patients are in the ER in the first place. Sure some are at risk of dehydration. But how many are sent there by on call docs “just in case of lawsuit” for an illness that passes in 24 hours?
My second concern is the number of other ER patients and caregivers –some at the ER for no good reason as described before– who may be getting infected while they wait around for hours.
SARS spread in a similar fashion in Canada, after all.
The outbreak surfaced in February 2003, when a woman from the Toronto area contracted the virus on a trip to Hong Kong and returned home, dying soon after. Her son went to a hospital with an unidentified condition that was later diagnosed as SARS. While waiting for 16 hours in a crowded emergency room, the man transmitted the virus to two other patients, and it continued to spread, the commissionâ€™s report says.