As a lead-in: a ‘Family Plan’ in the ED is when there are several patients in the same room, usually with the same complaint, but not always. For some reason nobody’s last name is the same, either, but that’s beside the point. I have always held that one of them might be ill, and the rest are there because, well, they’re there.
Now comes MDOD with a fiendishly elegant theorem: M.D.O.D.: The Snidely Whiplash Inverse Proportionality Theorem of “Family Plans”
Though I haven’t done the math, it looks about right from here.
You are too kind, sir. Fair winds and following seas to you and OORAH!
Worst I ever had was five in the same room… all siblings, all with chicken pox.
I was never unlucky enough to pull the bus full of schoolchildren, or the church van full of elderly neck pains.
The Family Plan is only an extension of the If-You-Walk-In-The-Door-We-Can’t-Refuse-You-Plan that EDs operate under.
If EDs didn’t get paid for seeing someone with the sniffles this problem would be figured out.
Let me add this. If I see someone in the office, sit down with them, and it’s clear within about 10-15 minutes that they have no business wasting their time in my office, I will say, “There is no point of you seeing me for this problem.” And I will go out, send them on their way and not charge them one penny.
There is no reason why EDs can’t operate in this same way.
Greg, you missed the point. We DON’T get paid for a lot of these visits, but under our current legal constraints (that aren’t going away) we HAVE to see them until we’re certain (to a legal definition, not a medical one) that there exists no emergency condition. By that time, it’s ‘here’s your tylenol prescription (free only if you have an Rx, you know), and out the door all of them go.
Just another joy of the ED!