Meet GOMER

In a recent post, I questioned why Emergency Room visits were so expensive. One major reason is this man. Well, sort of.

Children of the 60’s will recognize this man as Gomer Pyle, USMC, a.k.a. Jim Nabors. Actually, Jim has absolutely nothing to do with the high cost of ER care (at least, to the best of my knowledge!) BUT his alter ego, Gomer Pyle does. Well, sort of.

Let me backtrack for a minute.

As everyone knows, the medical profession uses many acronyms – I think that they are second only to the US military in this regard. They have MRI’s, CAT scans, IV’s, and ER’s. There are ECG’s, EMG’s EKG’s, and EMT’s – you get the picture. But, did you know that they have other acronyms that most people have never heard of? For example, one of my favorites is (you guessed it), GOMER.

GOMER stands for “Get Out of My Emergency Room”. It is applied to the many patients who present for care at the ER, but who really don’t belong there. However, the ER staff can never turn anyone away for care without risking fines, lawsuits and bad press. So, GOMER’s continue to pour into our ER’s nationwide.

GOMER’s fit in three distinct categories. First, we have regular patients with non-emergent conditions that could be best treated by their family doctor or even an independent Medi-Merge center. This includes patients with mild colds and flu, small cuts, abrasions, or minor breaks and sprains. Frankly, if your injury or condition is not life-threatening, will not require advanced testing, is not life threatening, and will not ever result in you bring admitted into the hospital, you probably don’t need to be in the ER, taking attention and focus away from those patients who truly need to be there.

The second group is the uninsured. Usually, these people DO need to be there, but they could have prevented this need by seeking medical attention at an earlier date. Typically, they become ill, but do not seek medical attention until the condition becomes so acute that they have no choice but go to the ER. I have a great amount of sympathy for these patients, but we need to offer them dome concrete alternatives for care before their situations become dire.

The third group is the homeless. They will often fake or create a condition in order to get a warm bed and some free meals. A common ploy is to eat cigarette ashes, which will create a temporary condition of acute gastric distress. They know that they will be admitted into the hospital from the ER, where they will have a solid day or two for testing and evaluation before they are released. Many of these patients are mentally ill or drug addicted, and will appear in the same ER over and over again.

All three of these groups are getting their health care at the single most expensive place in the world to get health care – a US Emergency Room. Many of them cannot or will not pay for this care, so the cost is passed onto those patients who can pay, and the end result is the $5,000 ER visit.

The sad thing is that there is little that anyone can do about this situation under the current system.

The best that ER staff can now do is to employ a tactic called “make them wait”. ER staffs will often ignore a non-emergency patient in hopes that they will leave and go elsewhere. Did you ever hear someone complain that they were in the ER, the place was empty, but they had to wait for twelve hours to be seen? Chances are, the triage nurse determined that they were a GOMER, and tried to make them go away.

The GOMER situation is very sad, as it represents the absolute worst in our health care system. Not only is it a fiscal waste, many people are not getting the care that they need in a timely and efficient manner. There is, however, a very simple solution to this fiasco. Want to know what it is? Stay tuned….




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