COMMENTARY

What Is a 'Medical Emergency?': An Expensive Lesson

Allan M. Block, MD

December 08, 2021

In mid-July my son strained his neck working out at the gym.

It was an obvious generic muscle pull. I told him to take some ibuprofen and use a heating pad. My wife, a nurse, told him the same thing.

Regrettably, while my medical training (hopefully) counts for something with my patients, it doesn’t mean much to my kids. The unqualified opinions of their friends and Google are far more worthwhile, convincing him he had any number of serious injuries.

As a result, while we were at work he went to the emergency department to get checked out. He was evaluated by one of my colleagues who did x-rays and a cervical spine CT. (I figure the last one was because my son kept reminding them I was a doctor). After all the results were in, the ED physician told him he had a muscle strain, and to take ibuprofen and use a heating pad.

Big surprise, huh? I’m sure he was shocked to find out that his old man knew what he was doing. Of course, I didn’t order any tests so the ED doc tops me for that in my son’s mind.

But kids not believing their parents is nothing new, and I can’t claim innocence either from what I remember of being a teenager.

Fast-forward to today. From what I can see, the total bills for his little adventure in modern medicine were around $4,000-$5,000. Granted, I’m well aware that what gets charged has no relationship to what’s actually going to be collected but I’m not going to write about modern medical charges or collections or even defensive medicine. I understand all those, and certainly don’t fault my ED colleague for how he handled it.

Reassurance isn’t cheap, though. When it’s all over, our out-of-pocket share will be roughly $1,000, which we certainly hadn’t planned for in the usually money-tight months of December and January.

That’s a lot of money for ibuprofen and a heating pad (we had both at home, and they’re around $20 total at Target, anyway).

There’s certainly no shortage of research on unnecessary ED visits for minor things, but to me this is a classic example of it. Beyond just the financial cost (which, admittedly, I’m pretty irritated with him about) he tied up a bed and ED staff that someone in more dire circumstances may have needed.

His injury could have been handled at an urgent care, or, even better, just by staying home, listening to us, and using ibuprofen and a heating pad.

We need to emphasize to kids — and the general population — that the emergency department is for emergencies, and clarify what constitutes an emergency in the first place. There’s no shortage of urgent cares and other walk-in clinics that are there specifically to handle such things during daylight hours, if they need to be seen at all.

Of course, I can’t change the results of Google searches, or the age-old teenage belief that parents are morons.

But he is going to learn about what constitutes an emergency, and what else that $1,000 could have been used for.

Block has a solo neurology practice in Scottsdale, Ariz.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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