As an emergency physician I promise it's not something we do on purpose to harm anyone. It's because people lie to us all. the. time.
I've had patients who were lesbian, with their partner, swear up and down that they only had sex with women who were pregnant not once but twice. I diagnose surprise pregnancies quite frequently. It's not that I don't trust you, it's that I can't fully trust anyone.
Edit:
I appreciate the thougtful comments I'm receiving on this. To help clarify - in the emergency department if I'm ordering a urine hCG I'm probably seeing you in triage, I have 5 to 7 minutes to see you, ask questions, perform an exam, and place orders. No I don't have time to review your prior records, I have 60 patients in my waiting room and 10 people after you to screen, 14 more checking in the next hour.
Respecting your autonomy, your sense of self, and being an ally are very important to me. But I've also had patients believe they had a hysterectomy when they didn't because health literacy is hard. If I'm seeing 60 to 80 patients in triage in a shift my first priority is minimizing mistakes and misses.
I don’t know why the upreg is the thing that gets fought so much more than even tox screens. Babe I just want to make sure this isn’t all being caused by the massive hormonal, metabolic, and anatomical changes of pregnancy I promise I’m not judging if you fuck or not.
(I did once have someone say it’s a privacy concern which would be fair except you’re in the ER, I have your full name, DOB, and blood with me and I’m about to have you strip naked into a gown. Privacy isn’t real here.)
To the person who said I’m calling them a dirty filthy lying whore then blocked me: no, I’m really not. I need to know if you’re pregnant or at least producing hcg. Lots of people don’t think they are when they are. Lots of people lie. Lots of people have other reasons they’re pumping hcg. Lots of people get drugged and raped and don’t remember. Lots of people block out memories. Lots of people lie to THEMSELVES. Lots of people have lots of unprotected sex. None of these people are worth my scorn or judgement. Everyone is doing the best they can with what they have.
It pissed me off because (pre Obama care days) I had to pay for a pregnancy test that I knew 100% I didn’t need to get treated for a yeast infection or whatever
I get it, but I was poor and didn’t have insurance.
Yeah healthcare is way way way too pricey but I’m very tired of hearing people yell about their upreg being expensive (true) but not their on arrival bloodwork (also true, and also probably not giving great info). I agree it’s extremely expensive to get it done and I’m very sympathetic to that because I’m not taking my life extending medication due to cost. It’s ONLY the upreg (out of all the normal tests we run) that gets people THIS lathered, though.
It's probably because they understand what the pregnancy test is for but not what the blood tests are for. The blood tests are vaguely medical to them so they can see those potentially being useful, but since they're certain they aren't pregnant (regardless of the actual chance of pregnancy), that seems like a charge that will be unnecessary. I don't agree with it, but I do get why they're thinking that way.
I guess it is mostly people without insurance taking issue? I've always had insurance and I've never seen the urine test itemized as a separate expense. Typically it's just one charge for the copay or for the labwork (blood and urine).
Yeah, and again, system issue, not an issue with the validity of upreg. I’m also uninsured and also not taking medication because I’m uninsured and likely shortening my lifespan by decades.
Like, sure, there are lots of good reasons (as you said) for a pregnancy test in triage. However, women are proveably systemically ignored in medical settings. Feeling like someone is ignoring you saying that you can't get pregnant when your bullshit meter for being ignored is in the crypt already is probably the cause.
Combine that with the fact that generally, women are the ones being asked about pregnancy tests, and there you go.
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u/TubesAndLines Aug 01 '26 edited Aug 01 '26
As an emergency physician I promise it's not something we do on purpose to harm anyone. It's because people lie to us all. the. time.
I've had patients who were lesbian, with their partner, swear up and down that they only had sex with women who were pregnant not once but twice. I diagnose surprise pregnancies quite frequently. It's not that I don't trust you, it's that I can't fully trust anyone.
Edit: I appreciate the thougtful comments I'm receiving on this. To help clarify - in the emergency department if I'm ordering a urine hCG I'm probably seeing you in triage, I have 5 to 7 minutes to see you, ask questions, perform an exam, and place orders. No I don't have time to review your prior records, I have 60 patients in my waiting room and 10 people after you to screen, 14 more checking in the next hour.
Respecting your autonomy, your sense of self, and being an ally are very important to me. But I've also had patients believe they had a hysterectomy when they didn't because health literacy is hard. If I'm seeing 60 to 80 patients in triage in a shift my first priority is minimizing mistakes and misses.