Calling the P-F docs please

[Balisong]

Once again, I don’t have much to contribute but this: I can personally attest that a quick spritz of carburetor cleaner will kill a black widow spider dead so fast you’d think it was the hammer of Thor. Which was fine by me.

A blow gun dart isn't fast, but it's interesting to see it try flee as it's pinned to the ground.

[Sensei]

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.

…and so ended you career as a hand model for L’Oréal.

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would go to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

[Joe in PNG]

…and so ended you career as a hand model for L’Oréal.

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

Could be worse- see Maple's comments about Canada.

[Coyotesfan97]

Two contrasting stitches visits: an ER in rural Texas. I split my left little finger open longitudinally between a downed sapling and another tree as I pulled the sapling loose. I sat in the waiting room for about three hours. The ER doc said, “There’s no point in stitching that up,” slapped a butterfly on it and sent me on my way. It “healed” as the ugliest, most puckered, messed up scar I have on my body. It crosses a joint, and limited my ability to span and fret notes on guitar for about three years until I worked it enough to stretch the scar tissue out. 5at stretching process helped it to shrink in size as well, thankfully.

Knife cut on a finger on a holiday weekend. Went to the local urgent care. I was in and out in about 35 minutes, with one of the tidiest sets of stitches I ever recal receiving.

I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.

I think I’ve been to the ER at least ten times for dog bites most of which were just punctures with no real laceration. Generally I went to ERs on the west side of my city. One is a trauma center and that’s where we usually take suspects. If there’s no tearing they’ll leave the puncture open to drain to prevent infection after they flush it out. If they do stitch they don’t close the wound tight so it’ll drain.

One time I went to an ER the east side for single puncture on my hand. The doctor that treated me told me it had to be sutured closed to heal. It got flushed out good and then she sewed it up. It was early morning so I didn’t argue. I’ll admit it was probably the most I was worried about infection.

[Hemiram]

I'm done with "Urgent Care" places after I had 3 trips where I was either misdiagnosed, or given the wrong antibiotic.

First one:

A friend and I were about 22 years old, and he and his future wife were living with his parents. His mom would "bargain hunt" clothes for him and she found what had to be the ugliest shirt at some place for $5.00. It was just hideous, and he said to me, "Hey, lets start wrestling around and grab my collar and yank it off!". OK, so I did it. The shirt might have been ugly, but it was very well made. I really had to pull on the collar and actually lifted him into the air before it ripped off. It was permanent press, which usually means it has nylon threads in the fabric, and one of those threads went in between my nail and the side of my finger. I thought I got it all out, but I didn't. The next day, my right ring finger is about 2X the size of my thumb and it's hot and hurts like crazy. Off to Urgent Care, and the doctor seems to think I'm crazy, "There is nothing in the nail crevice!", he said. The next day, it woke me up and I went to my GP who said, "There's obviously something in there!", and after numbing it, pulled out about a half inch long hunk of white nylon thread. I had to soak my finger in salt water and take antibiotic pills for a few days to resolve it.

Second one:

I had tons of ear infections as a kid, so I know when I am getting one. It was Sat night, and so I went to the same Urgent Care, but there was another doctor there. He looks into my right ear, and says, "Oh boy, you've got a good one going there!" and writes me a script for an antibiotic. By Monday morning, I was miserable, and my left ear was starting to hurt, so I called my GP and they told me to come in and they would work me in. I took the bottle of antibiotics with me, as I was going to be due for my next pill about 90 minutes after I got to the GP's office. He comes in and asks me what he gave me, and when I showed him, he rolled his eyes and said, "That's not an antibiotic for ear infections!", and then looks in my right ear and says, "Wow, it's a mess!", and then looked on the left and said, "It's almost as bad as the right one!!, when was the last time you had an ear infection?". I said, "1974", it was 1994. He put me on what normally would be the right antibiotic but my ears were too far along, and it did take the pain away for a couple of days, the infection and pain came roaring back to the point I was nearly totally deaf and had "stuff" running out of both ears. I ended up taking a hugely expensive antibiotic along with steroids and it resolved in a week or so, but one thing hung over. I started having problems with my Eustation tube in my right ear, and it slowly got worse over time, and in 2020, it would clog up and make my right ear somewhat useless, unless I held my nose and "popped" it. Doing so restored my hearing, but as time went by, the restoration lasted less and less time, eventually being 30 seconds or less.
At that point, I made a huge mistake and went to the local ENT physicians and they told me I had a very odd hearing loss, and my options were a hearing aid, a tube in my eardrum, or doing nothing. I decided to try the tube, and it did nothing but make my right ear useless. I had one Sunday morning about a month ago where my ear was "full" and I held my nose and popped it, only hoping it would take the pressure off and drop the Cicada like tinnitus I get sometimes. Instead, it BANGED loudy enough to make me jump, and for almost an hour, I could hear pretty well, but it went back to nothing. I'm convinced the balloon dilation of my eustation tube would resolve my problem, but insurance won't cover the $4000 cost. I am still getting bills for my cataract surgery, so I don't want to even think about popping for that until that is totally paid off, and one of my docs thinks it's not going to do anything, the other one agrees with me.

Strike 3.

I kicked a couch in 1996, and the next day I could barely walk, my whole foot and heel was purple. I suffered through it at work all night, and in the morning, went to an entirely different Urgent Care. I sit for a while and then go into a room and the nurse helps me take my shoe and sock off. "Wow!, That's horrible!", and then she left. About 10 minutes later, the doctor comes in, it's a neighbor of mine! I never knew she was a doctor. She and her husband were getting ready to build their dream home, and both of them, he was an orthopedic guy, were working all the time to save up money so they wouldn't have a mortgage, she normally worked as an ER doc in a local hospital. She looks at my foot, and says, "I think you have the gout!". "I kicked a steel framed sofa bed!". "I still think you have the gout!", and gives me a script for Colcrys. About 2010 I did develop gout, and this was NOT GOUT. I called my GP and he had me come in and I told him that "XXXXX XXXXXXX thinks it's gout!". He and the nurse started laughing, and said, "I'm pretty sure it's not, did she check your uric acid?". Nope, she didn't. They drew blood and came back and said, "Did you take any of that Colcrys?". I had taken one. He said, "No more, your Uric acid is a little low!". He ended up giving me some Percocets and an anti inflammatory and a couple of days later I was walking my dog again, and guess who I ran into? She asked me, "So the Colcrys worked?". I said, "Nope, but some percocets and an antiinflammatory did!". She still insisted I probably had gout.

That was it, I was done with urgent cares. I go to my GP's office or the one ER where they seem to know what's up.

[Nephrology]

…and so ended you career as a hand model for L’Oréal.

It is a sad commentary on our medical system that people need to go to an urgent care for a rash that might be Lyme or an emergency department for a cut finger.

In a high-functioning system, people would go to urgent care for a cut finger and schedule a next-day appointment with their family ”provider” for the for the Lyme. Welcome to America.

Not to mention the quality of care you are likely to be getting from your "provider" at said urgent care...

I’m not doubting there are poor providers at some urgent cares, but I hesitate to judge a place or a doctor based on what type of facility it is. After all, I hear a lot of negative crap about the high school where I work, yet we have some of the most dedicated educators I’ve ever worked with. I assume the same is probably true of most hospitals and urgent cares: nobody is there to neglect or harm the patients, but they could still suck at their job.

Sure fair counterpoint - for simple, non life threatening problems that do not require significant intervention, urgent cares are fine. However the biggest piece of the issue with urgent care is that emergency medicine (incl. urgent care...) is a specialty that has to be (strives to be) 100% sensitive for disabling/life threatening disease (i.e. it finds every single one, every single time).

Here is an illustrative example of the consequences when this fails to occur. Anyone with half a brain who laid eyeballs on that girl would have sent her by ambulance running code to a real hospital. Unfortunately, even half a brain was too much to ask from this particular "provider."

I'm sure computers can land airplanes quite most of the time too... I still like having human pilots