I can understand why an ultrasound might be needed in an ER sometimes... but why would ER visits affect the mamogram unit? Mamograms aren't usually an ER thing. Why is the cancer center being affected by the ER unit? Are they short staffed because they are sending tecs and medical staff to the ER?

I'm aware that some ER's and walk-ins are stacked up because of folks with coping issues and such- that's been in the news. I'm aware that some hospitals are having issues with occupied space pushing back some medical procedures. But I'm trying to understand why that would change scheduling of mamograms and the cancer unit?

I also suspect that the backup in certain areas, such as cancer testing and routine testing such as mammograms ,pap smears and routine check ups are due to many of them being cancelled or delayed because of the pandemic. It is no longer a steady stream, but a glut of patients trying to catch up on their routine Healthcare. Unfortunately, this has led to more advanced cases of illness because they were not caught sooner,which does not help.. Hopefully it will balance out eventually.

That had to be a very hard rejection to hear Moosemac. We had the same experience at the emergency room. My husband got very sick and I packed him in the car to get to the emergency room. There were many many people waiting and he was looking bad to me so I went to the desk to ask to speak to a dr. Nada. Then I saw a nurse go by, ask her when he could be seen as it was urgent. She answered "I can't help you" We waited two more hours and he looked like he was dying. I go around to the back of the hospital and go in a door I know is for the nurses. Walk into the area where the desk is and drs were there. I told them "I think his appendix has burst" Then I get action. One orderly got a wheelchair and we went and got my DH. They took his vitals and flew in to scan him. It had already burst and he was scheduled for early morning. I stayed with him. The surgery was very long which was unusual. He was in the hospital for ten days. Two weeks later I get a cold call from a Dr. from pathology. He had a tumor in the appendix and had to be seen proto. I called my Boston dr. and she said "bring him in." Long story short it was a muconous carcinoma and large which would spread more. Within half an hour he had surgery and was told it can spread to other places. We were so upset. Then my dr. said "not to worry, we will follow him with appt.s and he won't die. She was right, he's fine now at 88.

Had I not been aggressive, he would have died. Good luck with your wife, I feel good vibes for her. God bless you.

So sorry you and others are going through this.

People need to realize that the hospital not only place to be Tested for Covid.

Now, more than ever, we need to be our own advocates.

Moose, keep us posted. Wishing you the best outcome.

It's a culmination of a lot of things, primarily brought on by the pandemic. While I don't agree that ERs are overrun by people with mental health issues related to the pandemic, they are overrun with people who should be seen an an urgent care facility. But sometimes an urgent care facility is not available. I think staffing issues ARE a result of the pandemic, and it's mostly from the nursing side which trickles down to effect every aspect of care. It will probably be the reason I retire sooner than later. Nurses are sick to death of so many things from the administrative level all the way down to the patient level. Get used to it folks, it's not going to get better soon. We may not have socialized medicine yet, but we are starting to experience that we can't the immediate top notch care we demand.

I am so sorry your DD had to go theough those delays, and hoop jumping. May it all be a small blip.

Sleeperblues, I am pretty afraid of where we are headed with respect to the future of heathcare. I am counting on living near two top notch teaching hospitals keeping me safe, but who knows if even that will hold up.

Honest question here: I don't understand people going to the ER for coping issues. What could the ER do? Maybe they're having an anxiety attack, mistaken for something else?

I think there are people that are so frightened of Covid that they lose their common sense.

Every symptom must be Covid and must be seen by an ER doctor just to be sure.

Our parents, grandparents and ancestors went through crisis of similar magnitude or worse than the COVID and they coped without running to the ER. - OP

But did they cope? In our parents or grandparents eras no one ever spoke of having problems with mental health issues. My brother was schizophrenic, diagnosed in 1973 and my parents never spoke of him again with their friends. When they retired and moved to a smaller community my brother no longer existed because of the shame of his illness. You do remember all those horrible places that "those" family members were sent to don't you?

And if it was just covid, the virus, that was the issue, that would be one thing but it isn't. It's the isolation. the loneliness, the unemployment, the kids in/out of school issue, the ever changing information, the "will this ever end" question.

Mental illness has come out of the closet and so it should. Unfortunately there are some who believe in the attitude of "pick up your boot straps" and get on with it. There is still a lack of funding and trying to get into programs or trying to get appts with the clinicians can take months. So if someone is having an emergency, even a mental health emergency, what would you like them to do - take their own life or go to the ER in hopes of getting some help.

It seems to me that some empathy and some sympathy is called for.

I'm glad that your daughter had advocates who were able to persevere and get her an appt and that she will be fine.

I hope that those who are in the ER today with a mental health issue can get the same type of advocacy and care.

OP:, sorry you and your family are going this ordeal.

Just an FYI: i called my HCP yesterday, got an appointment on January 6th for mammogram followed by a dexa scan... 9 day turn-around, that's pretty great. doesn't seem like we have a back up where i live, as of right now.....

we live in a suburb outside of Philly

Yeah, I'm missing something. What does the ER have to do with cancer treatment, breast or otherwise? This is where I said we were headed quite some time ago. These are very limited resources. Use them wisely.

Blfenton, thank you for another perspective.

I am so sorry your DD had to go through this. It is all very unfortunate when it seems one person is the roadblock.

As the mom of a Nurse Practitioner who has many years as an ER nurse, I know she would say the ER case load has greatly increased lately. I hear about the general state of things all the time. She was formerly on trauma team at our city’s largest hospital, and of course those cases take priority if a declared trauma case comes in. She moved to a smaller affiliated hospital in an adjoining community for a promotion. Most times it was relatively steady until Covid. And I will say, most ER staff is trained to tell the difference between someone who has mental health issues and someone who is just using the ER as their primary care facility.

It is absolutely ridiculous how demanding and seemingly uneducated a lot of patients are about the ER. Many come in a couple of days after testing positive (yes, with full covid symptoms), wanting another test. Many just come in for drugs. One lady with Covid even said she needed to stop at WM on her way home to pick up toilet paper. Of course DD tactfully asks these idiots if they have quarantined. Most have weak answers about how they are taking care of their kids or grandkids, need to grocery shop, go to school, etc, etc because their spouse is at work. Are they overwhelmed? Possibly, but are they any more overwhelmed than normal? I get it, many dont have help when they do need to do every day errands but the ER is not the place to find it.

DD had managed to avoid Covid for almost 2 years. She tested positive 2 days before Christmas. So much for her Christmas celebration this year.

"those are serious but why is there a general lack of coping skills in entire generations? Our parents, grandparents and ancestors went through crisis of similar magnitude or worse than the COVID and they coped without running to the ER. What changed? Better yet, how do we fix the problem?

And finally, and this is my protective mother side speaking: Why in h-ll do these patients who just can’t cope, take priority over folks facing life threatening illnesses/diseases?"

I "just" had this convo with a GF whose husband is terminal....its what known up here as a sh!t show

I recently booked for a routine mammogram (I've never had a lump and breast cancer doesn't run in the family so there's no particular urgency in my case).  Last time I booked, I had to wait  3 weeks; this time, it's 3 months.  As I understand it, routine screening (as opposed to urgent screening) was put on hold for a while in the early days of Covid and they're still trying to catch up.  Add to that the arrival of Omicron and so many medical  staff having to isolate, and everything is disrupted.  There's a real and genuine concern that these kinds of delays in routine screening are ultimately going to cost lives.

I'm sorry about your daughter's struggles and hope she can get an assessment and resolution ASAP.

My wife's routine mammograms are done in imaging centers that are not part of a hospital. These places, as with separately standing surgery centers, are not as affected by Covid surges as actual hospital departments have been.

Other than for emergency services and seeing one's primary care doc, the people I know in Australia have said repeatedly that long waits for medical services and appointments are quite typical for patients using the universal care, Medicare system. Shorter waits, more comparable to what we experience in the US, are available there in the "private" healthcare system for those who supplement their coverage by buying so-called "private insurance". As many do.

I agree with sleeperblues. My daughter is a CCRN at the ER of a local hospital and although she has only been on the job for two years, she feels burnt out. There is such a staffing shortage that that she often works her 12 hour shifts with no breaks and frequently stays for 16 hours. She is constantly getting texts begging her to pick up a shift on her days off and the nurse to patient ratio in the CCU is abyssmal. The nursing shortage has a devestating trickle down effect.

"Other than for emergency services and seeing one's primary care doc, the people I know in Australia have said repeatedly that long waits for medical services and appointments are quite typical for patients using the universal care, Medicare system."

Waits for elective surgery can be lengthy; waiting periods for critical care of the sort described in the OP are not. And even with the longer waiting periods for treatment under Medicare, patients on average still have better access to care and treatment here than in the US, as numerous studies, both American and international, have documented.

My mammograms and outpatient EGD/colonoscopy are done at the hospital. They are affected by staffing shortages. My last EGD/colonoscopy took 4 months to do because of staffing/scheduling issues. Usually it is only a couple weeks to get one done. Not everyone goes to free-standing imaging centers or free standing surgery centers.

I am truly grateful for the dedication of the medical professionals during this crisis. The staff shortages coupled with the dramatic increase in volume is a disaster. They are true heroes.

As an update, DD was able to get her scans today at the local hospital. There was some confusion when she arrived for her appointment but thanks to her onoclogist and the team at the cancer center, she got her scans. She should have results tomorrow and we will go from there.

Just as a side note: There are no longer receptionists to check patients in at the cancer center, hospital lab, imaging center or surgical day. Those tasks are now being handled by the medical staff i.e. mostly nurses. Everyone is doing double duty. Today my daughter was checked in by the Radiologist who also performed her ultrasound.

Glad to hear you daughter was able to get the screening. I don't understand why there wouldn't be receptionists, though: that sounds like a really poor use of valuable medical resources.

"Waits for elective surgery can be lengthy; waiting periods for critical care of the sort described in the OP are not."

Define what you consider to be "elective" procedures. And, I thought many purely elective procedures aren't covered under Medicare?

Here's a recent example from a few months ago of a person in Australia- a foot injury was treated by bedrest for a few days and then keeping the foot in a "boot", a removable walking cast most are familiar with. Ten weeks later, the foot was still quite painful, mobility was restricted, and an x-ray showed that proper healing had not happened and surgery was required. My relative's GP recommended a specific surgeon. Contact was made - a 3-4 month wait if done under Medicare, or the following week if done privately. It was done the following week, privately. Is this elective surgery? Waits like this, typical in systems like the UK's NIH and in Canada, are not acceptable to people who reasonably expect prompt care and in Australia as in these places, services outside the public systems are available with much shorter waits.

People make appointments for medical care with telephones, not by consulting studies. In the US, people with insurance, which is the vast majority, get prompt care other than in extreme situations as have been prevailing during the pandemic. That there are some without coverage is a completely different topic.

"Not everyone goes to free-standing imaging centers or free standing surgery centers."

That's true, it does depend on insurance - PPO vs HMO- the medical group or affiliations one's doctors work in, and geography. Smaller towns and rural areas tend to have fewer alternatives and less capacity than do larger areas. And after all, so-called "surgical centers" developed as a way to free up more hospital surgical capacity by moving less difficult/serious procedures to a different site. In my area, they're numerous.

I've had timely colonoscopies and both x-rays images, CT scans and an untold number of MRI scans over the years and never any of those were in a hospital.

Elmer - I'm not going to get into yet another debate about this. Anyone who has lived in Canada, the UK or Australia understands the pluses and minuses of universal health care systems. Over all, all three deliver a better quality of care to the average citizen than the American system does. I have in the past referred you to formal studies from reputable organizations supporting what I say. You haven't once rebutted any of the claims made in those studies. Yet somehow you think that your anecdotes and personal experiences outweigh the value of formal studies involving rigorous analysis of a much wider spectrum of the health care systems of a number of countries. There is no point discussing this further: you can rely on anecdotes, I'll rely on data.

Every person I know or know well in Australia (about a dozen, not all in one place) has similar stories to tell. As do people I know in Britain. Anecdotal but consistent. No variations, Medicare services can have long waits.

You didn't respond to my question - do you believe the surgery for the Aussie who was in constant pain, couldn't stand or walk, and needed a procedure was "elective surgery" justifying a 3 month or more wait?

As before, you seem to think real knowledge comes from internet searches. Me refute "studies"? Not something I would do or consider even thinking about. I know enough people who actually do biomedical research and "studies" (do you?), who themselves know many are best taken with a grain of salt or need to be considered in light of many other factors. And who all have cautioned me about taking anything too literally. I pass that caution along to you at no charge.

If you don't want to keep discussing it, stop cherry picking what you consider to be information and stop bringing up a misleading and incomplete picture.

Elmer - as I've said, I'm not going to debate this with you. If you don't understand how to make effective use of information available on the internet to broaden your knowledge, that's your problem, not mine.

Edit to add: as for cherry picking, I don't believe you understand the concept. Citing a number of detailed studies from reputable institutions evaluating health systems is not cherry picking; citing your own personal experience of one health system as representative of what every American experiences definitely is.

The thing is, Elmer, that those who can afford supplemental medical insurance can access specialists who are not in the public health system. Not all practitioners will do work for the public health system. Those who cannot afford health insurance are treated at no cost to themselves, but due to the restricted number of specialists in the public health system there is of necessity a wait list. Those requiring urgent care receive it immediately, those whose issues are not urgent go on the waiting list.

The other difference is that each person chooses their own heath insurance, and level of cover, which they pay for (usually by payroll deduction), it is not dictated by the employer and goes with the person wherever they work or even if they don’t work. And we don’t have that ”only covered if you go to particular doctors” BS.

As a hospital RN, let me tell you why the RN would be acting as the receptionist. It is because no one wants to work let alone at a hospital.

All of us working in the hospital have been working extra for nearly 2 years now. We have been sick, seen more sick than ever before and definitely seen more death and sicker patients than we ever bargained for.

Many staff have left or retired because of all of these things. Guess what? No one else wants the jobs. My hospital has greatly raised the minimum wage and offers insurance based on your wage. We can't get workers!! We have reduced cafeteria hours, closed coffee shops, run extremely short on housekeepers, etc.

I'm not sure what the fix is.

A big difference between American and Canadian Healthcare is that in Canada, I have never known or even heard of anyone who lost their home or their retirement savings or lost everything due to a catstrophic injury or illnes. Not so in the US. We may wait longer to see specialists but urgent is always treated as urgent, no matter your income.

In the case of my endoscopy, my GI doc had me book through the hospital as he could fit me in right away as opposed to at their practice which was booked out 3 months.

Almost any medical procedure I've been involved in in the last 6 months. I've had a 2-3 month wait to be seen... unless we went to the ER with severe issues. And I've had my primary recommend going to the ER because they can do all the tests there, one stop, as opposed to trying to truck around from labs to radiologists, etc.

nekotish, I am Canadian. I have first hand experience of that system. It is not the happy land Canadians and left leaning Americans like to pretend it is. Healthcare is a scarce good on both sides of the border and it is rationed on both sides of the border. Mind you, the American system is well and broken, but Canada does not hold the answer. Ask the myriad of Canadian doctors living here. Germany, Switzerland, Singapore all have far superior systems. I think we point to Canada all the time because it is one of the worst socialized systems out there and thus keeps predatory American health insurance companies in business.

Canadians may not go bankrupt, but they have health care denied them and pay for that with their lives. Yes, overall, Canadians are better off than Americans because their poor receive better maintenance care than their American counterparts, however, health inequalities still exist between rich and poor Canadians.

Here is the story of a Concordia University professor who was denied proper medical resulting in her untimely demise. Canadians do not enjoy the ability to sue their healthcare providers for redress the way Americans can, so perhaps these stories are just seen as normal, or more likely, stories like these go unseen.

I can't seem to post links or copied text today. The Concordia professor who died needlessly at 43 was Nadia Chaudhri. Of course insured Americans are victims of such wrongs too, but let's just remember, healthcare is a good and one way or another, it gets rationed.

colleenoz, I have a general familiarity with how the system in Australia works. In particular, I've reviewed (a few times) the tiered choices one insurance company for private coverage offers (Gold, Silver, etc) as well as charges for "extras" also available. By US standards, the costs are modest. I suspect the average earnings of physicians in Australia (and I know in Europe too) are a good deal lower than in the US. Without regard to what's right and what's wrong, fee levels for docs as well as hospitals and other provider types do significantly affect insurance costs.

"due to the restricted number of specialists in the public health system there is of necessity a wait list."

The number of specialists in the public health system would increase if the system offered higher compensation. Queues are a means of rationing care and keeping costs low - more money put into the system would reduce queues. The surgeon I referenced above splits their time between the two systems, 3 days in one and 2 days in the other - I forget which was which.

The draw of providing private services is the significant increment to earnings by doing so. One of the people I know has an unusual condition that requires regular (and timely) doctor visits. The doc used is a professor at the local medical school. He also splits his time - you can see him two months from now as a Medicare patient, or next "later this week" as a private patient. It shouldn't work like that.

"we don’t have that ”only covered if you go to particular doctors” BS."

Only the lowest cost types of medical insurance here, called HMOs, have a mechanism like that. Referrals to specialists are also required. Their networks can be limited because such policies offer lower than market rates of reimbursement and some docs won't do that. Another type, less common, is what we have on the West Coast - Kaiser Permanente. It's a combination insurance company and medical group. Dating from WW2 era, it deserves kudos for being a low cost provider and criticism for often providing very poor care. Again, services are rationed, and queues exist as part of cost containment.

I believe a majority of covered Americans can choose their own docs having so called PPO plans (so long as the provider accepts their insurance policy's negotiated rates - and most do.) And don't need referrals for an office visit of a specialist. Allied procedures - xrays, scans, lab tests, do have to be ordered by a doc.

"I have never known or even heard of anyone who lost their home or their retirement savings or lost everything due to a catstrophic injury or illnes."

I've never known anyone who's had such an event either.

As far as financial disasters, the possibilities are endless - losing your home to a loan foreclosure, losing your car because of an accident when it's inadequately insured, losing a car because it was repossessed, starting a business that you invest your life savings in and it fails, or, having to go through bankruptcy for pending medical bills. All such misfortunes have back stories and contributing factors. Many can result from poor or unwarranted choices people make - hearing of the existence of any or many usually does not tell enough of the specific story to reach a conclusion about.

PS My Boxing Day and Victoria Day parties all heavily attended by Canadian MDs. Do you seriously think American Thanksgiving is as well attended by American doctors in Canada?

I realize my PS is far from my OP, apologies, just scroll up a bit if you missed it.

moose, I apologize for going so far OT. Believe it or not, I restrained myself ;-)

Nadia Chaudhri.

https://news.fifhy.com/neuroscientist-turned-twitter-legend-nadia-chaudhri-dies-at-44/

Thank you, yeonassky.

And thank you for fixing my poor spelling :-) I fixed it in my comment too.

"And I've had my primary recommend going to the ER because they can do all the tests there, one stop, as opposed to trying to truck around from labs to radiologists, etc."

I'm reluctant to continue in this thread but this comment got me.

Are you fibbing or is this true? Do you live in or near a populated area?

I'm shocked that a primary care doctor would direct a healthy patient to an ER when not medically necessary, that's irresponsible. Especially with what's going on in ERs with the Covid spike.

Lab work? Holy moly, there are more Labcorps and Quest Diagnostics locations than Starbucks or McDonalds. They're everywhere, even in small towns. A doc can submit the test orders electronically. Imaging centers? Not as numerous as labs but also all over the place, all serviced by radiologists. And if your doc wants you to use the imaging dept at the hospital, they can similarly submit an order for you. There's no need to use an ER.

If this comment is truthful and this is how your doctor operates, you need a new one.

I was hoping to read a response to the previous comment, to explain the circumstances or reasoning for what seemed like an ill-advised and questionable suggestion from a doctor.

Moosemac, i hope your daughter hears good news soon. As I just went through this process myself, and getting good news yesterday, I just wanted to tell you that during my biopsy procedure, they placed a tiny titanium marker to indicate the location has been biopsied, which appears during a mammo, in case there is any question.

Please let us know how your daughter is doing,

Blubird,

Congratulations on your good news! DD has several clips/markers from previous biopsies. For some reason this one did not get a clip which is part of the issue. They will be putting one in so this does not happen again. It will be a moot point in March when she has her double masectomy. The stress of scans and bipsies every 3 months has gotten to be too much so she has made this decision.

So sorry your daughter is going through this right now. It's never a good time, but these days, it's especially challenging, as we all know too well.

My youngest sister also had a recent breast cancer diagnosis. She is fortunate it was caught very early, and she lives in an area of the country with multiple choices for excellent care, along with very good insurance. This is sadly not the case for everybody, I know.

I don't know where you're located, but I have heard many reports over the past 2 years about how some areas in the USA may have only one medical facility, and some places with nothing that's close, due to so many hospital closings, and a shortage of medical professionals that's been developing for some time, well before we got hit with this terrible pandemic. This seems to be mainly in more rural areas, I understand.

People are going to ERs for COVID testing, despite pleas from authorities to use urgent care. It seems so much of those PSAs are not being received by those who need that info the most, but I also wonder if there may not be that much of a choice of testing facilities for some. Rapid test kits are in short supply right now, and some people think PCR tests must be purchased as well. Hopefully that will change.

carolb_w_fl_coastal_9b,

We are fortunate to live near Boston so there are a plethora of world class hospitals. However due to major staffing issues in all sectors of our economy here and the over use of the ER for non-emergencies, those hospitals are overwhelmed. I am grateful DD has excellent health insurance through her employer which has made navigating this journey easier. That coupled with her oncology team who have advocated for her through out this process has been a blessing.