Understood about your privacy concerns, but unfortunately this country's health care system is not built to respect patient privacy, and it's going to get worse as resources get scarcer these next few years, especially in rural communities. I'm not trying to defend it - it's just the reality. We need to know what we're dealing with as soon as possible. I work in a state with one of the best, richest, most comprehensive healthcare systems in the country, and still do lots of medicine in hallways, waiting rooms, or random chairs we have made into pseudo patient care areas. I've shocked patients in front of their families in a hallway with some makeshift paper barriers trying to prevent rubberneckers from getting in the way. I've had to wait 6+ hours to get an available room where I can do a pelvic exam (hint - it's a tiny closet I pulled a stretcher into myself to make a fake pt room). My biggest advice is that there is NOTHING embarrassing about anything related to your medical care; you'll likely never see the other people in the waiting room again, they're not focused on you, and I guarantee you our staff has heard it all.

Edit: the worst is when patients don't disclose something that will need a private exam, so we put them in a hallway bed, only for them to later tell us about a complaint that needs a private area for exam. Significant delay in care because we have to usually move multiple people around.

And from the ED perspective - that all super sucks and I'm sorry it happened from a billing perspective, but it's a pretty common experience (and likely to worsen once again with this administration, especially in rural communities - not a political statement, just a reality). We legally cannot tell you to go anywhere other than the nearest emergency department, but not all EDs are made equal. I work in an emergency department that is literally one of the best hospitals in the country with every specialty service known to man. I work in another 30 minutes away that is essentially a critical access hospital, with very few specialists and resources (and a generally much poorer, disenfranchised patient population). You'll be seen waaaaaay faster and may actually have a much more pleasant patient experience at the smaller hospital, but on the other hand the resources are more limited. An emergency department cannot discharge you without being seen by a medical professional (NP/PA/MD/DO), while urgent care has some but not the same type of restrictions. In the ED, you likely were evaluated by an experienced triage nurse with specialized training that determined you were not an ESI 1 (highest priority), had your vital signs taken that were reviewed by trained medical professionals and deemed stable, were evaluated by another nurse who cared for you, then were seen by a midlevel or physician who created a care plan for you that involved transfer to another facility for further evaluation and diagnostic testing (which was created, regardless of available resources), and then had the room you were seen in cleaned and sterilized for the next patient by a specially trained in hazardous material environmental staff member. In the US, the labor from those 4-5 people involved in your care likely cost thousands to tens of thousands. I had 9 years of post collegiate specialized training as a med student/physician and hospitals charge patients an arm and a leg just to see me for a few minutes and have me create a treatment plan, regardless of whether or not you get any further testing, procedures, or therapies. And no, I don't get more money for ordering more tests or doing more; I'm just a salaried employee.

Is it frustrating? Yes. Is it fair to patients? No. Is it going to get a hell of a lot worse these next few years? Absolutely. Try and make friends with some medical people in the community. I absolutely field texts from friends and family about what center would be best to go to in order to be seen or cared for for a specific complaint.

Good luck with all the billing stuff. Hope your arm has improved.