One day back in 2015, a patient came to our Emergency room, signed in, went through the triage nurse and just as he was about to be attended to by a physician, he snapped and simply left. He wasn’t suffering from a serious illness, I bet he had been stung by a bee and had a swollen nose. As per our regulations, we charged a minimal level for triage time through the normal V64.2 code. A few weeks later, after receiving his bill that we mailed to him, the patient came back to our facility fuming. He was throwing tantrums all around claiming that we were exorbitant and we were trying to extort some money out of him. He was threatening to press charges against our facility but after a few minutes of tête-à-tête with the manager, he was convinced and apologized for the fracas he had caused. Up until that moment, I had ignored the fact that there are millions of patients out there who have no idea on what can happen if they leave the emergency room without being seen. Today, we want to look into detail what some of the causes are for people checking in into the ER and leaving without being seen and what happens afterwards.
Some of the main reasons why people end up leaving before they can be seen by a physician include;
After being examined by the triage nurse, some people are convinced that their medical conditions are not as bad after all and they resort to leaving before they can be attended to by a physician. A good number of people don’t understand the meaning of triage and that it is meant to assign priority. When people are told by nurses that their situations are not as urgent, they imagine that they are not as ill after all and they end up leaving before treatment.
The other reason why people simply leave before they are examined by the physicians are the long queues. People are impatient at times and long queues can wind them up. Sometimes after seeing a triage nurse, some people are told that they will have to wait for up to 2 hours before receiving treatment and this makes them lose their cool and walk away.
Change of heart
Another peculiar reason why some people end up walking away from Emergency Rooms is a sudden change of heart. People just make up their minds not to see the physician having waited in line for some time. The exact explanation to this behaviour is not known but it is attributed to the gloomy atmosphere in most ERs.
So, having known why people end up leaving the emergency room without treatment, what happens to these people once they walk away? Are they charged? Is it dangerous in any way?
Well, depending on the facility that the patient went to, he may or may not be charged. I will use our own facility at Bellaire Emergency Room to explain what happens in most cases. If the patient walks away after being triaged by a nurse but does not see a physician on any other specialist, then we will only levy charges of triage. The physician will however not charge the patient even if he was supposed to be served next before he bolted. So long as the patient checked into the facility, was booked and was triaged, he/she will have to pay for the efforts and time spent by the nurses to triage him.
Some other facilities are lenient enough to let such patients walk scot-free. Even after being triaged, they are still left to go and will not be charged. Such emergency rooms are however very few and although they will not charge you, they highly prohibit such habits. They will sometimes levy a penalty on you if you are a repeat offender; leaving more than once before being seen. So, it is wise to walk away even if you have a valid reason?
Well, sometimes you may need to answer to another call somewhere, maybe there is an emergency at home that you need to attend or something of that sort. The best thing to do, is to talk to the triage nurse or the supervisor on duty and explain your situation. If possible, they will reschedule your visit if they feel that you are not in any imminent danger. If you are in a critical condition though, they will not let you walk away before you can see a physician.
Never walk away before you can see a physician. It not only is a health risk but can compromise with your insurance. Look, if the facility reports you to your insurance provider, they may refuse to pay for the triage fee and this can be inconveniencing. It is wise to wait until you are attended to before you can think about walking away.