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and what I say is not intended to be anything other than what I have observed personally, but it is what it is.
While all trauma victims (that are taken to trauma centers) are treated in the exact same manner (Trauma surgeons generally have their own routine of how and what they do and in what order). When the trauma team is dispatched, Trauma Protocol ensues. Everyone has their own function and they do it. This is always done in an Emergency Room setting. Once the patient reaches a stabilization point--then a secondary trauma assessment occurs. Treatment in this phase can include things like stitches, etc. and then transferring the patient to the appropriate level of care which can include ICU, inpatient, observation or home. The level of care generally stays at a constant level until the patient reaches the inpatient setting during discharge planning. It is really at this time where whether a patient has insurance or not that it becomes a factor.
The Discharge Planners will attempt to find funding and free beds in rehabs for uninsured patients--but many times, they cannot and the patient can be sent home with devastating injuries and pretty much left on their own--many young people will end up in Nursing Homes and in substandard conditions in their own homes because their bodily function has been disrupted. These are the cases that upset me. We basically throw away the ones that don't have insurance to do the best they can without any resources to do it. There is a high incidence of mental illness, drug abuse and suicide in these patients. Many times, their families break up because the spouse/SO cannot cope with taking care of them when they are in need of a higher level of care than they can adequately provide. These are people that are silently swept under the rug--and the statistics don't count. I have wondered more than once why we take extraordinary measures at extraordinary cost if we aren't going to finish the job. I have also thought more than once when you see the devastation--did we really serve this patient well by saving their life?
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