ER OVERCROWDING: AN IMMODEST PROPOSAL

I don’t have an inner child. I have an inner libertarian. The other day, he announced that he has the cure for ER overcrowding. The ensuing discussion went like this:

Catron: A Cure? For ER overcrowding?

IL: Yep. 

Catron: OK, I’ll bite. 

IL: Is it not true that GruntDoc, Scalpel, Nurse K, Whitecoat, Shadowfax, and other medbloggers are always lamenting the large number of drug seekers that clog up the ER, wasting everyone’s time and generally irritating patients, nurses and doctors?

Catron: Uh-huh.

IL: And these “frequent flyers” mainly want prescription pain medication, right?

Catron: Uh-huh.

IL: And the only people authorized to write those prescriptions are physicians, right?

Catron: More or less. I think in some states PAs can …

IL: Well, then, the solution to ER overcrowding is obvious, isn’t it?

Catron: Er … no.

IL: Come on, dude, think outside of the box.

Catron: You’re not suggesting …

IL: Yep. Get rid of state and federal statutes that forbid people from buying narcotics over the counter without a prescription.

Catron: You’re nuts.

IL: If the drug seekers aren’t required to have a prescription for the pills they want, they’ll stop coming to the ER and getting under foot.

Catron: But we can’t just let people buy drugs any time they feel like it.

IL: Why not?

Catron: They’ll kill themselves!

IL: That’s none of your business. Thes people are adults. It isn’t the function of the health care system (or the clinician) to be their Mommy.

Catron: Nonetheless ….

IL: We let people buy alcohol and cigarettes without a prescription, right? And people regularly kill themselves with these things—-do they not?

Catron: That’s different.

IL: Oh really? How so?

Catron: Er …

The conversation was interrupted at this point by my wife, who pointed out (gratuitously, I thought) that the grass in our back yard was not getting any shorter.

So, is IL on to something, or is he just another wacky drug seeker looking for a creative way to access an FDA-approved buzz? I don’t know. You tell me.  

Comments 4

  1. Joe C. wrote:

    IL is on to something. I know many people who have been harmed by the horrible drug laws in the US. What people do to themselves on weekends, no matter how dumb, is none of the government’s business. Unfortunately, the notion that drugs should be illegal is more or less universally held and absolutely not subject to debate.

    Posted 15 Apr 2008 at 11:12 pm
  2. Mark wrote:

    then when they come to the ED with an overdose, do we have an obligation to scoop them up out of their ditch?

    I doubt this is going to help.

    Allowing patients unfettered access to narcotics will only balloon the side effects thereof, and instead of a whiney fibromyalgic in room 8 for 3 hours, you’ll have trauma rooms with vents and narcan going strong.

    Posted 16 Apr 2008 at 8:13 am
  3. Nurse K wrote:

    Silly Catron—Not only do they want the prescription, the don’t want to have to PAY for it, so they use ER+ Medicaid ($1 co-pay).

    Posted 17 Apr 2008 at 10:45 am
  4. IL wrote:

    “They don’t want to have to PAY for it, so they use ER+ Medicaid ($1 co-pay).?

    Medicaid patients probably don’t account for more than 25% of the drug seekers who appear in an average ER. So, you’d still eliminate 75%.

    Posted 17 Apr 2008 at 4:36 pm

Trackbacks & Pingbacks 1

  1. From Trusted.MD Network on 16 Apr 2008 at 8:38 am

    Narcotics over the counter?…

    A proposal to stop ED overcrowding:
    We let people buy alcohol and cigarettes without a prescription, right? And people regularly kill themselves with these things—-do they not?…

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