美國的急診是這樣的, 這是全世界最好的急診 (by Steve Sanders, DO) Mike was seen at our local emergency department on a Friday evening with complaints of indigestion. (pepperoni pizza) He worried about heart disease and called 911. Physical assessment by the emergency resident physician came quickly followed by an EKG, chest x-ray, CT scan of the chest (“ they said I might have had a blood clot”), and lab, specifically including cardiac enzymes. Mike said his only complaint was it took over five hours before he heard any news. “Everything looks good,” said the resident. "but my attending thinks you need to stay for a chest pain evaluation. Your first cardiac enzyme was normal, but he thinks you need another evaluation in six hours followed by a stress test," Mike said he tried to protest, wanting to just go home. “Then you'll have to sign out AMA (against medical advice). We can't be responsible if you go home and have a heart attack and die,” The thought of dying at home also had him upset. He stated when he told his story to the Hospitalist, she just shook her head and laughed. “They just don't want to get sued,” she explained. “We get these normal cases all the time. We try to tell them this can be handled on an outpatient basis, but what can we do?” She laughed again, which Mike took as a good sign he was really okay. He left the hospital the following Tuesday—the heart scan machine was broken on Monday—with a clean bill of health and a diagnosis of “gastric reflux” ------------------------------------------------- 美國帳單! ambulance ride + emergency department evaluation + hospitalization + cardiac stress tests came to just under $11,000. --

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