So I'm working at my Urgent Care Center that one of my Emergency Medicine partners and I opened 2 weeks ago.  A 20-something kid gets dropped off by an old guy in a pickup and comes in complaining of back pain.  He says he and his parents recently moved from Louisiana, and he fell off the trailer that had some of their stuff on it injuring his back.  He had a microdiscectomy 2 years ago.

He said his mom was on her way from home with his insurance card.  Unlike the Emergency Dept., at the Urgent Care Center can ask up front for insurance, proof of ability to pay, etc. prior to rendering any services.  What a novel concept!  I can actually get paid for everyone I see!

This policy had been stressed to my new staff many times.  While I was seeing other patients, Monkey Boy gets put into an exam room without the "mom" arriving with his supposed proof of insurance.  After 14 years of this, I can get a pretty good idea when someone is coming in for a Demerol fix and a prescription for Vicodin, and my spider-sense was tingling as soon as I saw this kid.  He related his sad story to me, and since he gave a history of direct trauma (fall from height) and had vertebral tenderness, I was obligated to do X-rays (which were normal).

I gave him a shot of Toradol, an injectable anti-inflammatory, non-narcotic, and wrote prescriptions for an anti-inflammatory and a non-narcotic, non-sedating muscle relaxant.
He went up to the front desk to "call for his ride" several times which never materialized.  He asked me to call in his Rxs, which I refused to do until he paid for what had been done.  

After about 20 min of waiting around, he said he would need to leave before "Mom" showed up.  I told him if he did, I would call the police.  He waited around another couple of minutes, and then started escalating.  My nurse dialed 911 and he hit the door, jumping a 7-foot wall behind the building.  LEOs showed up about 20 min later.  I gave a detailed description, and the guy was found about 2 hours later after having called EMS for foot pain, requesting to be transported to San Antonio about 25 miles away.

I think he was a hitchhiker and he figured he could get a free ambulance ride into town and then disappear.  Unfortunately for him, P.D. monitors all 911 calls, and they arrived at the same time as the ambulance and recognized him from my description.  The nurse drove to the scene and gave a positive ID.

I won't recoup any of my fees/expenses, but I sure feel better.

Second great story of the night.

Sgat1r5

I guess it'll work out as long as my windows don't get smashed in and my computer and X-ray hardware doesn't get trashed/stolen.

Good to see another dirtbag going to jail.

Hurray! one less dirtbag sucking the medical system dry for the rest of us to pay for. Bravo, my good man and keep up the good work!

Quoted: Good to see another dirtbag going to jail.

+1   i agree.  

Quoted: ....and my spider-sense was tingling as soon as I saw this kid....

Funny how that happens, isn't it?

Congrats on your new urgent care practice.

You folks in the medical field should refuse services unless they present photo ID, birth certificate, proof of coverage, financial statements, or a combination of the above.  The rest of the world does not work for free, why should you?  -especially on something as important as medicine-

Quoted: Quoted: ....and my spider-sense was tingling as soon as I saw this kid.... Funny how that happens, isn't it? Congrats on your new urgent care practice.

Seems to happen all too often. A good friend works in urgent care and she turns away a handful of these types every week... Apparently her B.S. meter has become quite sensitive and she can pretty much call them as they walk in the door.

what a scuzball...nice job!

I gave him a shot of Toradol, an injectable anti-inflammatory, non-narcotic, and wrote prescriptions for an anti-inflammatory and a non-narcotic, non-sedating muscle relaxant

Good job getting him busted.  One little trick I learned from a crusty old ER doc:  Give a dose of Stadol or Nubain if they dont claim an allergy.  The partial antagonists will point a doper out when the withdrawals start.  

I supervise in a public hosp.
The other night I had to security to hold down a frequent drug seeked so I could de-access her life port and then still had to threaten to have her arrrested if she didn't leave.
Then she came back an hour later, said she'd kill herself, so she got admitted.

Another (Sat.) couldn't get pain meds for a H/A and we were going to discharge her, so she said: "I'm pregnant, I'm having headaches because I'm pregnant, so I'm going home and cut my baby out to relieve the pain...." She stayed.

I hate 'em.

Quoted: You folks in the medical field should refuse services unless they present photo ID, birth certificate, proof of coverage, financial statements, or a combination of the above.  The rest of the world does not work for free, why should you?  -especially on something as important as medicine-

We have people who steal medicid cards because they used theirs up, come in for drugs, but are recodnized by staff because they are in there so much. Of course they have no ID. I get risk management involved and go on about my business.

Quoted: I gave him a shot of Toradol, an injectable anti-inflammatory, non-narcotic, and wrote prescriptions for an anti-inflammatory and a non-narcotic, non-sedating muscle relaxant Good job getting him busted.  One little trick I learned from a crusty old ER doc:  Give a dose of Stadol or Nubain if they dont claim an allergy.  The partial antagonists will point a doper out when the withdrawals start.

NO SHIT: We had a guy in the ED, acting frickin' crazy.....had a big history.
Long story short, he's a 50+y/o adult playing a drinking game like "quarters", but instead of drinking they had to do a drug. He got Nubain IM.....I guess he forgot he was on methadone.
What a loser.

NO SHIT: We had a guy in the ED, acting frickin' crazy.....had a big history. Long story short, he's a 50+y/o adult playing a drinking game like "quarters", but instead of drinking they had to do a drug. He got Nubain IM.....I guess he forgot he was on methadone. What a loser.

Karma's a bitch.

Quoted: I love how the guy with back pain jumps the 7-foot wall.

Gotta love those adrenaline rushes!

Quoted: I love how the guy with back pain jumps the 7-foot wall.

Hey, he had a good doc!

Free care abuses are somewhat expected.  

Interesting that the price goes up for pay care for the same reasons, abuse of services.

you should invest in one of those magnetic locks so you have to buzz to let them out.

sorry, can't go anywhere til you pay up.

Essayons