U.S. hospital/medical knowledge needed!

[Senator Cybus]

So, I'm writing a thing, and I need to have certain characters present in the waiting room of a North American hospital when a certain event takes place...

I've never been to a hospital in the U.S., so I lack a few wee bits of knowledge. Specifically, the following:

Would someone in the U.S. go to a hospital for a case of acid reflux? Would someone go to a hospital to have a retainer/braces removed (and what's the difference between the two? I thought I knew, but a Google check has left me bewildered!)? If the hospital caters to mostly wealthy patients, is there even still a communal waiting room, or do patients get a private area while waiting to see a doctor?

Oh, and for bonus, you're-so-helpful karma points, can anyone think of an illness that would require someone to be initially hospitalised, then allowed to leave but advised to try and avoid physical contact with others for a while, either because they're still infectious or because it might cause said condition to resurface?

These probably seem like weird questions, but any help would be greatly appreciated. :smallsmile:

[SarahV]

Acid reflux: you would probably go to your primary-care doctor, in a doctor's office. Not a hospital.

Retainer/braces removal: You would go to a dentist for that, not a doctor. They have their own, separate offices.

Not sure about wealthy-person hospitals, never been to one :smallwink:

A hospital is generally more for major problems that need urgent or specialized care/equipment: you are in an accident and need emergency care, you are having a heart attack, you are having trouble breathing, you need to have some kind of surgery, you need a CAT scan or MRI, you need to have intensive 24-7 care... those are hospital problems. More everyday/non-life-threatening things like a sinus infection, acid reflux, chronic high blood pressure, etc. you would go to a regular doctor in a doctor's office.

How about some kind of immune-suppression problem, for your last question? They get very sick with something due to the bad immune system, then it's cured but their immune system is still compromised so they should not be around other people... ? Or it could be some kind of psychological problem that makes them want to avoid other people, and they were hospitalized after having some kind of severe episode while in a crowd of people.

[Coidzor]

So, I'm writing a thing, and I need to have certain characters present in the waiting room of a North American hospital when a certain event takes place...

A general waiting room, emergency room waiting room, or a lounge area, such as can be found by the general entrance?


Would someone in the U.S. go to a hospital for a case of acid reflux?

Possibly, though only those who believed it was something more serious than acid reflux or who were lacking health insurance would and only if they thought it'd be worth the long wait.


Would someone go to a hospital to have a retainer/braces removed (and what's the difference between the two? I thought I knew, but a Google check has left me bewildered!)?

That's something one goes to an orthodontist who is either part of a clinic or private practice for. If there's some kind of medical emergency, one would go to the ER to get the retainer extracted from where it had become embedded in one's flesh or some other kind of catastrophic occurrence.


If the hospital caters to mostly wealthy patients, is there even still a communal waiting room, or do patients get a private area while waiting to see a doctor?

I don't think that's a thing per se, being more the sort of thing a private clinic would do.

It depends on exactly what you mean here though. Emergency Rooms are always going to have a waiting room for processing people who are getting admitted/going through triage. Out-patient procedures are usually set up so that the person signs in and then reports to a room that's not a general waiting area in my experience.


Oh, and for bonus, you're-so-helpful karma points, can anyone think of an illness that would require someone to be initially hospitalised, then allowed to leave but advised to try and avoid physical contact with others for a while, either because they're still infectious or because it might cause said condition to resurface?

I believe Mono can result in someone having a collapse or pass out so that they'd get taken in to the ER, and, well, people generallly recommend that people with mono not spread it around, and it is sometimes known as the kissing disease.

[Senator Cybus]

Thanks for the quick response! :smallbiggrin:


Acid reflux: you would probably go to your primary-care doctor, in a doctor's office. Not a hospital.

Retainer/braces removal: You would go to a dentist for that, not a doctor. They have their own, separate offices.

Ah, right. The same as for us Brits, then. I was a bit confused as the U.S. hospital-based t.v. shows I've seen (a not entirely reliable source of information, it appears :smallsmile:) seem to have patients turn up for all sorts of minor things.


How about some kind of immune-suppression problem, for your last question? They get very sick with something due to the bad immune system, then it's cured but their immune system is still compromised so they should not be around other people... ? Or it could be some kind of psychological problem that makes them want to avoid other people, and they were hospitalized after having some kind of severe episode while in a crowd of people.

Yeah, this is exactly the kind of thing. I'm thinking probably the problem with the immune system rather than something psychological - are there any helpful passing doctors who could throw me the name of such a condition? Pretty please?

Also, if the braces thing isn't realistic, I need another reason for one of the characters (a fourteen year old girl) to be there - are there any illnesses/conditions that are seen as somehow 'childish', in that they're seen as something a kid would usually get and might be embarrasing for a teenager?

[Senator Cybus]

A general waiting room, emergency room waiting room, or a lounge area, such as can be found by the general entrance?

I guess sort of a general waiting room or lounge. Basically, the characters would be either waiting to see a doctor, being discharged or, in the case of one of them, a doctor himself who was just passing through. None of the characters would have serious, immediately life-threatening complaints.


If there's some kind of medical emergency, one would go to the ER to get the retainer extracted from where it had become embedded in one's flesh or some other kind of catastrophic occurrence.

Eeeew! :smalleek:


I believe Mono can result in someone having a collapse or pass out so that they'd get taken in to the ER, and, well, people generallly recommend that people with mono not spread it around, and it is sometimes known as the kissing disease.

Interesting; that's a possibility. Thanks!

[CoffeeIncluded]

Also, if the braces thing isn't realistic, I need another reason for one of the characters (a fourteen year old girl) to be there - are there any illnesses/conditions that are seen as somehow 'childish', in that they're seen as something a kid would usually get and might be embarrasing for a teenager?

Maybe she got really sick--sometimes "simple" food poisoning can be bad enough to warrant hospitalization.

[Senator Cybus]

Maybe she got really sick--sometimes "simple" food poisoning can be bad enough to warrant hospitalization.

Thank you, and yeah, maybe; ideally I'm looking for something that's a sort of 'kids get this' kind of thing - it's relevant later that this character is in a hurry to grow up and wants to be seen as an adult.

[snoopy13a]

Thank you, and yeah, maybe; ideally I'm looking for something that's a sort of 'kids get this' kind of thing - it's relevant later that this character is in a hurry to grow up and wants to be seen as an adult.

Really the only thing I can think of that would be remotely close is the chicken pox. But that doesn't really work because: 1) Now there is a vaccine for it & (2) a teenager or adult getting it was seen as a fluke not an embarassment

What you could do is have the teenager be sick with the flu on a Saturday night and have her overbearing mother take her into the emergency room. She wouldn't be embarassed over her illness per se, but rather her mother's behavior and the fact that she got taken to the emergency room in the first place.

[Rawhide]

Thank you, and yeah, maybe; ideally I'm looking for something that's a sort of 'kids get this' kind of thing - it's relevant later that this character is in a hurry to grow up and wants to be seen as an adult.

Actually, mono fits this bill pretty well... Often contracted as children, and often called the kissing disease, because that's one of the main ways it's contracted, but not the only way.

Alternatively, it could be complications with her first period.

Also, a list. (http://en.wikipedia.org/wiki/List_of_childhood_diseases_and_disorders)

[NerdyKris]

Would someone in the U.S. go to a hospital for a case of acid reflux?

This would be an urgent care center, not an ER. Also known as a walk in clinic, they're intended for things that can't really wait, but aren't major emergencies. In smaller towns, this would be done by a doctor's office. Yes, people might go to an ER for acid reflux, except that would be frowned upon, and expensive. Acid reflux is very easily treated, and would never be an emergency. If they were in extreme pain, they can just take baking soda and water and neutrilize all the acid in the stomach at once. (Actually, that's the active ingredient in all antacids, plus painkillers.)


Oh, and for bonus, you're-so-helpful karma points, can anyone think of an illness that would require someone to be initially hospitalised, then allowed to leave but advised to try and avoid physical contact with others for a while, either because they're still infectious or because it might cause said condition to resurface?


LOTS of them. Almost anything would fit that example. Hospitals don't want patients taking up beds in America, they're for profit. Once the immediate danger to the patient has passed, the patient would be sent home. It's assumed you'll take precautions to avoid infecting others. You can't be held against your will in a hospital in America for that except in extreme cases like Typhoid Mary.

Also, hospitals in America cost money. Emergency rooms cost a lot of money. Even with insurance, it's $100 for me. A walk in clinic is $25. Your characters, unless they don't have insurance (ER's can't turn people away, walk ins can) and intend to default on the bill, or have a lot of money and no concept of cost, are probably unlikely to spend $100 on acid reflux.

[Thajocoth]

For acid reflux, there are usually no doctors involved. You go to, like, Target or somewhere like that, get some pills for it, like Prilosec, and take them. I did that over a year ago. It never came back.

For braces removal... That would be an orthodontist's office. If the dentist believes you need braces, they would refer you to an orthodontist to get them. As far as I'm aware, the orthodontist deals only with braces... Their installation, tightening, removal, etc... Pretty similar to a dentist's office, except dentists I've been to always had patients separated and the orthodontist I went to had an open row of chairs like you might see at a barber shop.

[The Valiant Turtle]

It should be mentioned that severe acid reflux literally travels the same nerve that the chest pain from a heart attack uses. My dad has had several heart attacks and can normally tell immediately when one is occurring because he's familiar with his symptoms. 2 years ago he went in with chest pains and both him and his cardiologist were quite shocked when it turned out to be reflux. It's not exactly common, but it does happen.

Note that many urgent care clinics are only open during the day, so if something happens in the evening that can't wait until 7:00am the next morning it's certainly possible that people would go to the Emergency Room. Some ER's have a section for less severe issues that in my experience has always been called "Fast Track". In many cases that will be staffed by Nurse Practitioners or Physician's Assistants - but they'll call in one of the regular ER docs if needed. That will end up being a bit cheaper than a regular ER visit.

Trying to think of something "childlike" that someone might be in the ER for is difficult. Mono's reputation as the "kissing disease" means that it is almost seen as a teen thing, because of the theoretical kissing involved. I'd recommend head lice as an option, but I can't imagine anyone going to the ER for that even in the most extreme circumstances. Chicken Pox really isn't a bad idea. As mean as kids can sometimes be I can envision them teasing someone about it being a kiddie disease - kids and teens are typically well versed in how such things actually work.

I can think of something that might help. In some cases a very large hospital will have a floor or adjacent building with regular doctor's offices in it. Basically the hospital is leasing space to the doctors. Typically these would be specialist offices though, not family practitioners or pediatricians, although it might not be that big a stretch to have a pediatrician's office in such a location - especially a specialist pediatrician (which is exactly the case I'm familiar with) These offices may share a semi-common waiting area somewhat like the waiting areas at in airports where there's a cluster of seating around each gate. I think it's common for such places to refer to themselves as "Medical Centers" instead of just "Hospital". In these cases the actual Hospital might refer to itself as being part of the Medical Center. The waiting areas wouldn't typically be close to the ER though.

I'm familiar enough with most aspects of healthcare to give you a pretty detailed run-down of anything you might need. Feel free to ask.

[Melayl]

Regarding Reflux: if the patient did not know/understand they had reflux and had a sudden, severe episode (usually accompanied by chest pain), they may go to the ER believing they're having a heart attack. I have seen this several times in the ER.

Edit: Read all the posts before posting... ninja'd

[Senator Cybus]

I can think of something that might help. In some cases a very large hospital will have a floor or adjacent building with regular doctor's offices in it. Basically the hospital is leasing space to the doctors. Typically these would be specialist offices though, not family practitioners or pediatricians, although it might not be that big a stretch to have a pediatrician's office in such a location - especially a specialist pediatrician (which is exactly the case I'm familiar with) These offices may share a semi-common waiting area somewhat like the waiting areas at in airports where there's a cluster of seating around each gate. I think it's common for such places to refer to themselves as "Medical Centers" instead of just "Hospital". In these cases the actual Hospital might refer to itself as being part of the Medical Center. The waiting areas wouldn't typically be close to the ER though.

Right, okay, this might be just the sort of thing I'm looking for...

So, assuming that all the characters involved would be pretty well-off financially, would it be feasible to have one guy in the semi-common waiting area who's there to see someone about severe, stress-induced acid reflux, another guy who's there waiting to have a benign but unsightly growth removed from his chest, a third guy being discharged (the 'still technically infectious' guy) and the 14 year old kid, who's there with chicken pox because of an over-protective mother?

(Also, there needs to be a fifth character there who's a doctor, specifically a surgeon, but presumably he could be there for any number of reasons, even just taking a shortcut from one part of the medical centre to another.)

Given that they're all non-emergency patients, with no immediately life threatening ailments between them, does this sound like a feasible, normal grouping of people that one could reasonably expect to find together in that setting?

I'm probably way overthinking all of this, but I'm going for verisimilitude here! :smallsmile: Thanks to everyone for the input so far!

[Traab]

If you want something ER worthy that is embarrassing and something you can get as a kid, might I suggest intestinal migraines? AKA Cyclic Vomiting Syndrome.


An Introduction To Cyclic Vomiting Syndrome (CVS)

The CVS is characterized by bouts of acute nausea accompanied by vomiting. This condition might or might not be accompanied by headaches. The cyclic vomiting syndrome which is also known as intestinal migraine generally occurs in children, though you would in rare cases find it affecting adults as well.

The statistics suggest that as many as one in every fifty children may suffer from this problem yet they have not been diagnosed correctly. Be careful when you explain the symptoms to the doctor so he could reach the correct diagnosis early with ease.

The triggers for CVS or intestinal migraine could be anxiety caused by going to school, bullying by other children, emotional stress due to parents fighting, excitement over happy times such as Christmas, birthdays, etc. Try to carefully watch the child to identify and understand what factors aggravate the problem. You would be surprised with the speed of recovery once the trigger has been isolated and removed from the environment where the child lives.

I had this and it was TERRIBLE. It was stress induced and could last for hours of pain, vomiting, and belching up the stench from hell. The stench belches were often the first sign of an incoming attack, and it was VERY embarrassing to start doing that in class and having everyone around me start to retch because it hangs in the air like a cloud of stink. I suffered from this for YEARS before a specialist was finally able to identify it.

[scurv]

Oh, and for bonus, you're-so-helpful karma points, can anyone think of an illness that would require someone to be initially hospitalised, then allowed to leave but advised to try and avoid physical contact with others for a while, either because they're still infectious or because it might cause said condition to resurface?

These probably seem like weird questions, but any help would be greatly appreciated. :smallsmile:

Maybe if they received a transplant due to the immune suppressing drugs that are taken. Kidney or bone-marrow Might make this outpatent enough for your needs.
Tuberculosis maybe on the infectious standpoint.

Although You might want to consider something shellshock/ptsd like. I been to the VA dozens of times taking my father there and I have seen some patents that could not interact at all in crowded/social situations.

[Senator Cybus]

Maybe if they received a transplant due to the immune suppressing drugs that are taken. Kidney or bone-marrow Might make this outpatent enough for your needs.

Ah, yes, that works! So he's there, being discharged, advised to avoid mixing with people for a while because of the drugs...

So that guy's there with that, the teen girl's there with chicken pox to see the specialist pediatrician because of her over-protective mother, the other two guys are there with a growth to be removed, and severe, recurring acid reflux. Yeah, that all works...thanks all!