People disobeying orders

Headline in today’s Montreal Gazette:

Despite pleas to stay home, Montrealers flooding ERs

People still getting sick, despite orders. And most doctors taking a vacation. Nasty people.

It looks to me like the thrust of the article is about not clogging ERs with patients who may have influenza but can be treated at home, so that people with more serious ailments can be seen and treated faster (not to mention being safe from flu viruses spewed all over the waiting room and treatment areas).

And I must have missed the part where they said the docs are off on vacation.

Really - crowded ERs, selfish physicians - in freaking Canada??!?!?!?

Uh, you need to keep reading:

Seems like good advice.


Because every sickness has a gestation period of ‘right now’ and every doc needs to be here right ‘effin’ now.

If there was anyone I would expect to follow such a directive, its the Canadians. They are usually so damn polite and obedient in everything I’m surprised this wasn’t the lead story world-wide!

This wouldn’t be such a problem if every ER on the planet didn’t keep every patient waiting for 2 hours. Some simple, basic triage at the door would weed out kids with the sniffles. Of course, then they couldn’t charge thousands of dollars just to write a prescription for an unnecessary antibiotic. Or is it different in Canada?


To be fair, they formed clear lines and did not push or shove when flooding the ERs.

When there’s a flu season on, the ER (particularly the waiting room) is the last place I want to be!

Just yesterday, I went to the pharmacy (next room down the hall from the ER at the hospital) just to get a routine med refill. The lines this time of year are always unusually long. Just standing in that line among all those (presumably sick) people made me nervous.

Yes. Yes it is.

In the US at least, every patient who presents to an Emergency Department seeking care is entitled to a Medical Screening Exam by a qualified provider and stabilization within the abilities of the facility of any identified emergent medical conditions. This is why wait times are two hours (on a good day).

USCDiver, MD

Back when I worked in the emergency department, I was always surprised by the people who would bring their kid in to the ER for an ear ache or other such minor things (if they had insurance, at least).
My parents never took me to the ER when I was a kid. They would only bring us there if they were worried we were deathly ill.

I can remember one shift when I had to work despite having an URI and my voice was very hoarse…I could tell some of the patients were a bit thrown off that I was sicker than they were. :slight_smile: It was a little awkward, but calling in sick wasn’t really an option.

You really think single payor has ANYTHING to do with the phenomenon of not-really-sick people flooding the ER in flu-season. Since Christmas Day, our ERs (US) have seen approx 30-50% increase in usual volumes.

USCDiver, MD

Dont take your kid to the ER for colds or the flu?? But then how will they get their antibiotics?!?!

In the mail from Mexico like everyone else.

Granted the article was different from the headline, but I thought the headline was just priceless. As for vacations, I deal with several medical professionals and they are all away between Christmas and New Year’s.

But the ERs don’t charge a cent for residents. And if you get an Rx for a drug, it is probably correct. I think most of the ERs do do a triage pretty early on.

It turns out, BTW, that the current flu vaccine was not really right and there is more flu than usual. That’s a good reason to stay out of the ER.

I’m sorry, but we do express displeasure at don’t-get-sick orders.

Perhaps they need a doctor’s note, but not from this doctor.


I can’t speak to the situation in Quebec, with regard to hospitals, but it sounds similar to what we have in Ontario. A large part of the problem is the tax department. The doctors are advised by their accountants, that they should ration the amount of service that they provide, so they limit the amount of hours that they work.

So now people flood the ER’s during off hours and weekends, for stuff that was covered by family physicians, as you waited till the next day. The next bright Idea, several years ago, was to open satellite facilitys and call them urgent care clinics, that bleed off some of the surge from the ER’s, but since there is an acute shortage of available doctors in the pool, the clinics have staggered hours of operation, and people get fed up and head directly to the ER.

The next shift in thinking was to enable the tele-medicine service, so that people could phone in symtoms and be told the proper course of treatment or what not.

But its the Christmas season and people over indulge and some of them are going to get sick, hurt them selves and so forth.

So my solution was to have the urgent care clinics being staffed by nurse practicioners, with a doctor on call tele-remotely. For those we could be using the doctors that are staffing the provincial prisons. The UCC’s would run 24/7 and people would log in to make the appointment and get a text message for the time window booked, + or - so many minutes, and a separate parallel system for folks who for what ever reason don’t even have a wifi equiped cell phone.


Happens in Albuquerque too. Pancreatitis-- and I couldn’t get a room at one of the largest hospitals in the state–I think a lot of people had skipped their flue shots.