# Are doctors coming to the US in "droves" because they are "fed up with socialized medicine"? **URL:** \ **Category:** Factual Questions\ **Created:** [August 9, 2009, 10:39pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876 "2009-08-09T22:39:03Z")\ **Posts on this page:** 12\ **Page:** 3
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [August 11, 2009, 3:28pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/41 "2009-08-11T15:28:56Z")
> [@Boozahol\_Squid\_P.I](#): > > Your friend is quite wrong. EMTALA laws in this country protect anyone coming into an ER from questions about their payment until _after_ they’ve been seen by a physician. Every hospital I’ve worked in has had a very strict wall between clinical personnel and financial folks in order to safeguard against these sorts of accusations. Well, it depends: Here’s the procedure whenever I’ve gone to the E.R.: First I go to the triage nurse. If it’s life threatening emergency obviously the doctors take care of me right away. Otherwise (that is, it’s an urgent, but not life threatening situation) I wait for a while, then I’m seen by one of the accounting staff who takes down my insurance information, and THEN I’m seen by the doctor. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [August 11, 2009, 4:16pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/42 "2009-08-11T16:16:37Z")
> [@Patty\_O\_Furniture](#): > > An interesting observation: US citizens seem to be going overseas in droves to have elective surgery done. Myself, I’m going to have dental bonding done when I go to southeast Asia in december at $220 per tooth (US cost is a whopping $1400 per tooth). Gee, I wonder why those Thai dentists aren’t flocking to the states to get rich off of us cash cows. They are. Instead of moving they’re getting your cash cow money to fly over there. ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [August 13, 2009, 4:46am UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/43 "2009-08-13T04:46:46Z")
Personally, I’ve had bad experiences at Bumrungrad Hospital here in Bangkok, and I know others who have, too. Complaints run off them like water from a duck; they seem interested only in praise. Samitivej and BNH hospitals are much better, in my opinion. And prices at all of the private hospitals here have spiked in the last few years. Thailand is not as good of a deal as it once was. India is attracting a lot of the trade away from Thailand now. ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 13, 2009, 5:32am UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/44 "2009-08-13T05:32:18Z")
> [@suranyi](#): > > Well, it depends: Here’s the procedure whenever I’ve gone to the E.R.: First I go to the triage nurse. If it’s life threatening emergency obviously the doctors take care of me right away. Otherwise (that is, it’s an urgent, but not life threatening situation) I wait for a while, then I’m seen by one of the accounting staff who takes down my insurance information, and THEN I’m seen by the doctor. They still have to treat you though even if you are homeless and have no insurance. ---
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [August 13, 2009, 8:20pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/45 "2009-08-13T20:20:15Z")
> [@Shagnasty](#): > > They still have to treat you though even if you are homeless and have no insurance. I’m sure you’re right, but I haven’t tested it. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [August 13, 2009, 9:17pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/46 "2009-08-13T21:17:39Z")
> [@Shagnasty](#): > > They still have to treat you though even if you are homeless and have no insurance. Not quite. The hospital has to treat people who are emergency cases. If you walk in they can refuse you. If you want to guarantee getting treated come in an ambulance. If a walk in gets treated they will be sent a bill and vigorous collection will follow. ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [August 13, 2009, 10:35pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/47 "2009-08-13T22:35:58Z")
> [@gonzomax](#): > > Not quite. The hospital has to treat people who are emergency cases. If you walk in they can refuse you. If you want to guarantee getting treated come in an ambulance. If a walk in gets treated they will be sent a bill and vigorous collection will follow. You can’t get blood from a turnip. If you have no money, there aren’t any consequences for using the emergency room. We don’t have debtors prisons in the U.S. I am not sure about them having the ability for them to turn anyone away anyway. The person wouldn’t be there unless they had a bad cold or a broken toe at the very least. All someone like that would have to do is complain about chest pains or alcohol withdrawal and not worry about the ambulance. They have to take you at that point. ---
**Author:** ![BigT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigt/32/12044_2.png) [@BigT](https://boards.straightdope.com/u/BigT)\ **Post date:** [August 13, 2009, 11:44pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/48 "2009-08-13T23:44:51Z")
> [@Shagnasty](#): > > You can’t get blood from a turnip. If you have no money, there aren’t any consequences for using the emergency room. We don’t have debtors prisons in the U.S. I am not sure about them having the ability for them to turn anyone away anyway. The person wouldn’t be there unless they had a bad cold or a broken toe at the very least. All someone like that would have to do is complain about chest pains or alcohol withdrawal and not worry about the ambulance. They have to take you at that point. I know from experience that they will pretty much force you into bankruptcy if you can’t pay them. They are doing it to my family right now. Just because we happened to get into a wreck out of county, so our insurance wouldn’t cover it. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [August 14, 2009, 12:26am UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/49 "2009-08-14T00:26:17Z")
Your health insurance is only good in one county? That’s even worse than mine. ---
**Author:** ![Boozahol\_Squid\_P.I](https://avatars.discourse-cdn.com/v4/letter/b/d9b06d/32.png) [@Boozahol\_Squid\_P.I](https://boards.straightdope.com/u/Boozahol_Squid_P.I)\ **Post date:** [August 20, 2009, 1:15am UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/50 "2009-08-20T01:15:32Z")
> [@Shagnasty](#): > > They still have to treat you though even if you are homeless and have no insurance. They have to _stabilize_ you. If you’ve come in with a nasty hangover or a case of athelete’s foot, you’re already stablized. ---
**Author:** ![Boozahol\_Squid\_P.I](https://avatars.discourse-cdn.com/v4/letter/b/d9b06d/32.png) [@Boozahol\_Squid\_P.I](https://boards.straightdope.com/u/Boozahol_Squid_P.I)\ **Post date:** [August 20, 2009, 1:16am UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/51 "2009-08-20T01:16:32Z")
> [@Shagnasty](#): > > The person wouldn’t be there unless they had a bad cold or a broken toe at the very least. You have never worked in an emergency room, obviously. ---
**Author:** ![Backcountry\_Medic](https://avatars.discourse-cdn.com/v4/letter/b/919ad9/32.png) [@Backcountry\_Medic](https://boards.straightdope.com/u/Backcountry_Medic)\ **Post date:** [August 20, 2009, 4:39pm UTC](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876/52 "2009-08-20T16:39:33Z")
> [@suranyi](#): > > Well, it depends: Here’s the procedure whenever I’ve gone to the E.R.: First I go to the triage nurse. If it’s life threatening emergency obviously the doctors take care of me right away. Otherwise (that is, it’s an urgent, but not life threatening situation) I wait for a while, then I’m seen by one of the accounting staff who takes down my insurance information, and THEN I’m seen by the doctor. [QUOTE=gonzomax] Not quite. The hospital has to treat people who are emergency cases. If you walk in they can refuse you. If you want to guarantee getting treated come in an ambulance. If a walk in gets treated they will be sent a bill and vigorous collection will follow. [/QUOTE] These are misconceptions. I’ve worked in several different emergency departments and none of them have operated like this. Firstly, you can assume that once you have been seen by the triage nurse, you are under the ‘care’ of a doctor. I know, I know, they haven’t seen you yet, but every ER has a medical director that has created (or at least approved) standing medical orders for how we should treat different cases as they present to triage. Sometimes while you are waiting, the registration/billing/insurance people will call you and take care of some paperwork in the meantime, but they aren’t checking your ability to pay or anything like that, just making sure we have your current info on file, a copy of you DL, etc. Where I currently work, you could come straight back to a room after triage, even for minor injuries, provided we have ample beds and don’t anticipate using them for more critical patients in the near future. In these cases, sometime during your visit, someone will be by to get your info, or you might give it at the very end of your visit when you are checking out. Sometimes it’s most efficient to get it while you are waiting in the lobby for 3 hours and don’t have anything else to do but stare at all of the sick people. It still has absolutely nothing to do with checking your ability to pay for any services you might recieve on that visit. You can tell them that you’re flat broke and won’t be able to pay one penny, but they still have to see you all the same. Secondly, the ER doesn’t have any ability to turn \*\*anyone \*\*away. Nor does coming in by ambulance ensure that you’ll be moved ahead of people way sicker than you are (so please don’t try, it just pisses us off). The most general rationalization is “If you thought it was enough of an emergency to come in (or call 911, or drive to the fire station, etc) it’s enough of an emergency for us to be required to treat it.” Of course there is broad misunderstanding of what constitutes a true emergency, but if your stubbed toe, or sunburn, or hangnail, or lice, or whatever seemed serious enough for you to come in, you’re going to be treated for it. Just understand that if it doesn’t pass our ‘true emergency’ filter, you’re going to wait until everyone who has a more serious medical condition is treated before you are. So if you come to ER for lice (ambulance or walk in) bring a book or two. [Previous page](https://boards.straightdope.com/t/are-doctors-coming-to-the-us-in-droves-because-they-are-fed-up-with-socialized-medicine/505876.md?page=2)