So I twisted my knee when the dogs tripped me on Monday. Not wanting to be

[hedgehog]

stupid and ignore a possible torn tendon, I called my family doctor, described my injury and was instructed to apply ice, use ibuprofen and elevate the limb. I followed directions and now feel only an occasional twinge. Total cost:$0.

If I didn't have a family doctor and had gone to urgent care?

If I didn't have the money for urgent care and had gone to an Emergency Room?

[Tansy_Gold]

1. You're lucky to have a "family" doctor who treats over the phone

Or maybe not.

A friend of mine did that a few months ago when she fell off her bike on a routine ride. Her wrist hurt but she didn't think she'd done any serious damage. Called her "family" doctor -- she has insurance -- and he said put ice on it, take aspirin or ibuprofen, take it easy. It didn't get better, but she thought it would take time. Four days later, wrist is swollen, pain is unbearable, she goes to the doctor, he says hmmm something's not right, gets x-rays and finds three fractures. Two surgeries later, she still doesn't have full use of her wrist.

Now, you can say it was her fault, or you can her doctor isn't as "good" as yours. And it's possible that even an in-person visit wouldn't have disclosed the seriousness of her injury.

But just because you got lucky this time doesn't mean you'll always have the same good fortune.



TG

[hedgehog]

3. I should have made it clear that I was asked several pertinent

questions about what hurt, how bad did it hurt, could I walk etc and given instructions to call back the next day if there wasn't significant improvement and to go to Urgent care or the ER if things got a lot worse after office hours. My point was that because I've had continuity of care from a board certified family doctor, I was able to get the information I needed quickly and at marginal cost. The cost of the phone call goes against overhead and is built in to my routine visits, of course.

[Tansy_Gold]

4. Continuity of care indicates you have or have had insurance

I did, too, for 20+ years through my husband's employer. When my husband died, I got COBRA -- at $300+/month -- for 30 months. Four years later and without a job that provides insurance, I'm uninsured and, with a pre-existing condition, uninsurable. So I just wait and hope nothing happens until I turn 65 in four more years.

I have,however, our long-time family doctor who will refill prescriptions over the phone and give me discounted rates for office visits (once a year). This involves a 120-mile round trip drive, too.

But for someone who has never had long-term insurance, it's not that easy. Urgent care or the ER are the only options, other than doing nothing.

As I said, count yourself damned lucky.



TG

[hedgehog]

5. Oh, I know that I'm in a much beter situationthan a lot of people.

I guess what I am saying is that if we made certain that everyone had access to continuity of care, things would be cheaper for all of us. How much money gets wasted every year because simple problems end up in the ER being treated as major problems?

If you've hurt yourself, you need advice. If the only place to get advice is the ER, you go to the ER. I'm not blaming people, I'm blaming the system.

[Quantess]

2. The same exact thing happened to me, only worse.

I had problems with my knee just a few months before. At an off-leash park, my dog and another dog barreled into my knee and knocked me over. The pain and swelling came on slowly over the next couple of days.

So, I got out the crutches and stayed off that leg, but after 3 weeks of pain, and not being able to walk, I went to my general practitoner for my knee and my sudden onset of severe depression due to my injury. She could only offer the usual RICE home treatment, and said that only a CT scan could determine whether I needed surgery. But a CT scan is at least $400, and, if surgery is warranted...then what? Pay another few thousand out of pocket? I decided that my best option was to keep resting at home, because I couldn't afford a CT scan and surgery.

It took 6 weeks before I could walk again, and eventually I was able to go jogging again. But just last week, after some heavy lifting, my knee hurts again, and I can only walk a few steps at a time. I'm sure there is something wrong with my knee that can only be fixed with surgery. I'll have to wait until I get insurance.

[Hassin Bin Sober]

6. What did you do to the dogs that they felt the need to trip you?