this post was submitted on 18 Mar 2024
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#notanexpert . my understanding that ER/ED basically only have moderate responsibility to judge that you will not die and sue them in the next ~24h after an event. they tell you to seek further primary care when discharged.
The job of EM is stabilization and resuscitation. That takes a wide array of forms depending on your presenting condition. There is no “time limit” on what entails a safely dischargeable condition—if you present with chest pain, we CT you, and don’t find an immediately emergent cause of your chest pain, but in the process we fail to tell you about the lung nodule on your CT that turns out to be a CA that kills you in several years we are still liable. Maybe in certain states we are not medical legally liable at that point, but I would argue that we ethically still are. We are still all physicians (unless you’re getting treated by an APP).
In the context of stabilization and resuscitation I personally have the take that if you present with something I can’t adequately diagnose in the ED (let’s say I can rule out life threats but you still have a condition that is compromising your quality of life) then for the next step I really have to ensure adequate follow up for you (subspecialty referral, etc). That goes for the underinsured as well. It can get tricky, but that’s what case managers and social workers are for. Maybe I’m just biased because I work in academics. In general if you need emergency care I highly recommend that you go out of your way to get to an academic center because you’ll be more likely to get plugged in in this regard.