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ER economics 101

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This past week, I was sent my doctor to the ER for treatment of a boil.  I’m doing well, thank you, but it was a huge pain.  Certainly more of a pain than wild animals, but not as much of a pain as hail; overall, I’d give it a 6 out of ten.

When I got to the hospital, the ER was packed; there was not a single seat available in the waiting area.  The only time people seemed to get up was in order to yell at the nurses for their not having seen a doctor yet.  Doctors had to run from room to room in order not to get mobbed by impatient patients.  At one point during the evening a doctor broke down and, after a patient yelled at her that he had been waiting five hours, screamed back at the patient complaining about her terrible working conditions and paltry salary.  More words were exchanged, but I don’t know enough swear words in Russian to translate properly.

By the end of the night, I had waited eight hours to see a doctor.  In retrospect, my waiting was partly my fault.  Medical care is a resource like any other and I should have been looking at this situation using economics, the study of who gets what and why.

Hospitals are overcrowded; doctors are resource in a terrible shortage.  One of the jobs of the nurses is to sift through the patients and prioritize so as to use the resource in the best possible way.  This means that seeing a doctor has more to do with one’s relative priority to others in the ER and less to do with one’s time of arrival.  While many try using intimidation to make themselves look like more of a priority, the better strategy is to wait until a time when there is not much competition.

When a doctor sends gives you a referral to the ER, ask him or her if you need to go ASAP or if it can wait until around 3AM.  If it can, then go home and relax before going to the ER.  Doing this can reduce your waiting time from as much as eight hours to as little as thirty minutes.

Two more things to note: (1) Yelling at the doctors will not help.  They are not the ones under-staffing the hospitals.  If you want to yell at someone, look up the MK’s phone numbers and call them. (2) If possible, try to always to go the hospital with food, a book, an iPod, and, if possible, even a laptop and a couple of movies.  You’re going to wait anyways, so you may as well plan your own entertainment in order to make the time go by quicker.

In an ideal world, our government would get its act together and help provide better medical care for its citizens.  Until that happens, the best thing you can do is to be understanding of those trying to provide you with medical care and to do your part as well.


6 Comments

  1. Rachel says:

    depends on how the hospital is run as well. I know I wait much, much longer if I am silly enough to go to Ein KAren instead of Shaarei Tzedek. Same number of people, much better organized.

  2. rutimizrachi says:

    I like your attitude. We cannot change the world around us, surely not in a day or two, and surely not by screaming at the other inmates. 😉 We can only change how we cope.

    Your approach depersonalizes the problem. It’s not something that’s being done as an affront to the individual. It’s just the way the system is (poorly) organized. You remind your readers that all of the players are suffering, not just the patients.

    You come up with solutions that make the situation more tolerable until it can be fixed (please G-d).

    In the merit of your efforts to help others, I hope your pain has disappeared. 🙂

  3. Zvi says:

    A call to Benny Fisher (Magen Lacholeh) at 02-644-2000 would have prevented this blog post from being written.
    Next time you have a medical issue, call him and he will tell you where/how/when/why/what to do….

    • jonnydegani says:

      Update: Magen Lacholeh is for cutting through Israeli bureaucracy and finding the right doctor, the right time etc. It is a great service and a wonderful charity, although not really practical for minor issues, like the one addressed in this post.

  4. You didn’t mention anything about Urgent Care. I don’t know if that would have been an option, but in cities like Jerusalem TEREM can do almost anything except for surgery, and the Kupot seem to support it with their discount costs to go there.

    • jonnydegani says:

      Hi Robin,
      You’re correct, terem does a lot. In this case, terem provided me with the referral to go to the hospital.
      I have Meuhedet, which has its own internal terem (my wife has Leumit and I know that they do not).

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