Hospitals requiring upfront cash payments

As unflattering as it may be it seems that doctors are supposed to offer their services for free and it's about time someone has the "nerve" to do it. Tell me any other profession that would go unpaid for services. Ask your mechanic to fix your car for free!!!!

Your mechanic doesn't charge you over a year's salary for not doing anything!

as an ER physician in practice for 15 years why is thie 'news'. Why do we need to commision a study to tell us this? where have unfunded mandates, like EMTALA, caused anything but chaos? I'm quitting the ER in two months. I am going to work for less money and regular hours. I am not alone. I believe I am on the cusp of an exodus from ER medicine because of EMTALA and not just because we give away care to anyone who comes through the door or calls 911. The reason I'm quitting is that it is now unsafe to practice ER medicine in my community because, surprise surprise, consultants are opting out of call and opening off site centers while surrendering their hospital priveleges. You can replace most workers with a thre week training program. You can replace me with 8 years of post graduate training (which is a bitch), and you can replace a surgeon with 9 years of post graduate training, a much bigger bitch. Good luck turning lead into gold.

The ambulance service I work for is only getting paid for 40% of its work so we can shuttle the uninsured and underinsured to the clinic for gout, tooth aches, back pain 2 weeks old, etc..

Patients tell me they call 911 because they "can't afford a bus" or "cabs cost money." People seem to think that healthcare is some unlimited artesian tit you can just drink from whenever you want with no concept of money.

EMTALA never meant free care for everyone. It only meant that emergency care was provided without doing a wallet exam first. I'm glad hospitals look at these patients to ensure they don't have any immediate life threats, then kick them out to the lobby before asking them to pay their share. Why I have to pay for both myself and them? I'm sick of watching our ambulance rates climb for the insured because the uninsured deadbeats don't pay.

It's like some sick communism.

Re you mention that, "this week the Wall Street Journal brought some unflattering attention to the M.D. Anderson Cancer Center, which in late 2006 asked a leukemia patient for $105,000 up front because it wasn't satisfied with her insurance coverage."

Whom should the hospital have asked for the money? No service (including healthcare, can be provided free. SOMEONE pays for everything of value that we consume. Why is it scandalous a provider of service asks the recipient of services to pay for them? We expect people who consume news to pay for their newspapers; why are healthcare workers vilified when they ask to be paid for the services that they provide?

I don't have much love nor respect for Emergency Department Physicians. Being a former EMT and ICU Nurse Tech, I developed a wonderful pain syndrome called RSD. Reflex Sympathetic Dystrophy, changed in the mid 1990's to CRPS, Complex Regional Pain Syndrome, and although I am on some hefty doses of pain meds, when I am told to go to the ED by my Pain Management Physician or PCP, I go against my will because their lack of knowledge of any pain syndromes is atrocious. Not only that, but God forbid they should call my pain doc or PCP for a recommended dose of IV meds, because I am sick and tired of hearing "I don't want to give you anything because it puts me out of my comfort zone" and I am thinking, I am in agony, have insurance and what about my "comfort zone", Then if I bring up JCAHO's Pain Guidelines, the ED Physician will say they are "Contractors" and therefore are not held to JCAHO's Pain Guidelines, yet if they should contact JCAHO, as I have filed complaints about the lack of care I have received, I am informed the Emergency Department IS HELD TO JCAHO's PAIN GUIDELINES. I tore a muscle over the last Thanksgiving holidays, went by ambulance as I didn't have any cash on me and was in agony, never even saw an ED Physician. He yelled into the room at the RN asking her how my left shoulder looked and she yelled back, well, it turns in a lot more than her right shoulder. I was given one IM pain dose and sent my merry way with a piece of paper saying I had a "Sprained Shoulder" and after two weeks of more agony, I called both my pain doc and PCP and was admitted to my contracted hospital, seen by my Medical Group's Shoulder Orthopedist who ordered an MRI, which should have been done the day I presented in the ED, and a torn muscle that runs under the ligament to my collar bone, this my "left shoulder leaning in greater than my right shoulder", was admitted for a week of pain management and OT.

It doesn't take a moron to figure out any soft tissue injury is not going to show up in an X-Ray, and an MRI should have been ordered than night I went in by ambulance, and had to wait in the ED for three hours before even being seen by the RN.

America's care in the ED for chronic pain patients is atrocious, we are treated like drug addicts if we ask for pain meds, when my little pharmacy at home is obviously not working any longer.

So for the poor ER Physician who is going to quit the ER in two weeks for less pay, I say good by and good riddance, because doctors like you obviously have forgotten the Hippocratic Oath you took when you became a Physician.