The root of my comment was to defend the availability of ER services against someone who literally suggested that ERs were not needed for anyone who didn’t arrive by ambulance or by police, not to argue the specifics of his child’s case for which neither one of us have any real knowledge.

I am sorry about your wife’s experience. It contributes to making healthcare discussions so challenging, because there are incredibly emotional, stressful, and unfair situations in each direction (people who got billed tens of thousands on one side; people who were not diagnosed on the other) — including in countries with socialized medicine.

I would suggest that your wife would have been best served not by an ER doctor, but by a highly trained and thoughtful primary care physician who could have followed her and understood what she’s going through longitudinally. Sadly, we burden medical students with $200K in debt and then ask them to choose between a high-paying good-lifestyle specialty or a low-paying poor-lifestyle specialty.

And then one layer down, the primary issue is it’s hard to pay PCPs more when 99.5% of their visits are for common colds, medication renewals, knee pain, etc. and 0.5% of their visits make huge impacts (e.g. diagnosis of cancer early). Just like trying to discriminate urgent care vs. ER, how does one know which patients to send to an NP who can take care of routine issues, and which to send to a PCP with a better understanding of complex issues including management of multiple specialists’ recommendations.