3/19/08

In the United States COMMUNITY Hospitals are required to give emergency treatment to anyone who presents to the Emergency Department with an emergency (if the hospital has an emergency department). A physician must assess the patient to determine if there is an emergency. Because of the professional standards for physicians, and because of civil liability, there is a moral obligation to treat assessed patients. This means that most anyone who presents to an ER (in a Community Hospital) will be treated.

Many hospitals have endowments, grants, and other funds to help pay the bills of patients that cannot pay. One must ask for such assistance at the hospital’s financial department. They may not be obligated to offer, one should ask. In many facilities the eligibility terms are very generous. One would not need to be indigent or independent to get assistance.

While county health facilities may be reserved for truly indigent patients, many areas of the country have free clinics that are privately funded, and which will treat patients who cannot pay. There are also a number of clinics that will give free medical care to people who cannot pay, but are not eligible for Medicaid. It is up to the individual to apply for, and receive a letter of denial for Medicaid coverage, and then to ask the clinics if they can provide care.

The shoulder joint is very complicated, with a number of different structures. There are muscles, tendons, nerves, cartilage, bone, bursa, blood vessel, fascia, and other structures in the shoulder. A normally healthy and well-developed younger person will tend to have self-limiting joint injuries, if severe trauma is not involved. These injuries range from bursitis, and strains and sprains, to separations (subluxations). Dislocations are not common, tend to be obvious, and restrict range of motion (movement). Torn rotator cuffs also restrict movement.

Pain in most minor injuries is not immediate, but develops within 24 hours. It will grow worse over three to four days and then begin to subside. Full recover can take several weeks. Immobilization, cold compresses (for the first three to four days) then heat (don’t sleep on a heating pad), and over-the-counter analgesics and anti-inflammatory medications (follow the directions) are frequently recommended. Over-the-counter liniments such as Tiger Balm (the white preparation) can be helpful.

Chiropractors are physicians with a doctoral degree. They specialize specifically in the alignment of the vertebrae, and problems that arise from vertebral misalignment. They are generally licensed to diagnose, treat, and bill for health care problems within their scope of practice. Chiropractors can be very effective physicians, but may have little to offer to people who suffer injury in areas other than the back.

I hope you feel better soon.

LMK

Probably edited for spelling, grammer, punctuation, or typos.