A few weeks ago I was sitting at my desk, just before noon, when suddenly a large spidery shape appeared in my vision. I tried brushing it away but could not, it was inside my eye. Shortly afterwards a jet of what turned out to be blood shot across the visual field of the same eye, from one side to another, occluding perhaps a fifth of the surface. It darkened into an archipelago of fine black dots.
I went to my eye doctor, who examined me. She diagnosed the shape as a floater, much the largest she had seen, and the dots as probably blood. She did not detect retinal detachment but wanted me to see a retinologist that day. The office had several on call and I was able to get an appointment over the phone.
They saw me as part of the their normal flow of patients, and he diagnosed the problem as the shrinking of the vitreous causing a hemorrhage. No retinal detachment. Had there been detachment, when prompt surgery is important, he could have done it on site; the retinologist's office had an attached surgery.
Elapsed time -- including travel -- just over 3 hours.
That's pretty damned impressive. In Canada you can wait much longer than that in an emergency room even when you are bleeding and in pain. You can wait weeks to see a retinologist. Of course you won't have to pay much for it when finally you do: you can lose your eyesight on the cheap.
This day will cost me a fair bit, and I am sure when all the bills arrive I will wish I still lived in Canada to have them paid. But at the time, and now, and had there been detachment, I would prfer to get the better care promptly. It will cost me, but in less happy circumstances I might have lost vision had I been in Canada rather than Michigan. That's worth something.