After reading this thread and what happened to my dad last summer(he's okay now), I get the feeling that ER doctors are not real good at diagnosing things. First, my condolences to those who have experienced medical issues that have had negative outcomes. I am going to pre-apologize because I'm probably going to say some things that you might not want to hear and may upset you. ER doctors are generally trained to handle emergencies - myocardial infarctions/cardiac arrest, wounds, trauma, life support, etc. Their specialty is dealing with the obvious and the immediate, and not necessarily diagnosis of something you can't see or feel. Like someone said earlier, they get a lot of people coming off the street for stuff that they should be seeing a regular primary care doctor about. A big part of the issue too is the patient being able to verbalize and communicate accurately what they are feeling, which is the key to diagnosis of anything they can't see. If the patient says they "feel funny"... what's a doctor supposed to do then? If someone comes in with "arm pain and jaw pain", that might not be high on the list of symptoms of arterial blockage and may be higher on a list of symptoms of something else. My condolences to you and your family, but arterial blockage is something that occurs over time and is something that regular visits to a primary care doctor or cardiologist would be better at diagnosing than an ER doctor. The key is a doctor's "specialty". What is it that they are trained specifically to do? Every "doctor" does not know everything about everything. Go to a specialist in the general field of what the issue is, not the ER. If that doesn't yield the best result, do some research to find out what the top clinics/centers/doctors in the nation are in that field and go there. Brian, my best advice to you to help your wife's condition is to look outside of Milwaukee. Milwaukee is not a mecca for the cutting edge of medicine and research. The money it will cost you to fly somewhere and stay for a week/month/whatever to see the top specialist in that field would probably be a lot less than what you have spent so far based on what you have said. A quick story about someone I know. This person had numbness in their leg and foot for some time, and no diagnosis after several tests. He, being in the medical field, went to the top specialist at Keck-USC and found out he had a tumor on his spinal column. Extremely difficult surgery with a high probability of paralysis or death. When he went back to schedule the surgery he found out the doctor was gone and they wouldn't tell him where he went. He spoke to the doctor's former nurse, and she called him privately to tell him the doctor moved to Miami to work at the best spinal surgery institute in the nation, training under the doctor who, IIRC, did Christopher Reeve's surgery. So he flew to Miami to have the surgery done, and not only did that doctor do the surgery but the head of the institute who did Reeve's surgery assisted with it. He stayed in Miami for nine months pre-and-post-op. After being told that paralysis would likely be the best outcome, almost a year later he is walking around and back to work part-time. Not 100% yet, but the outcome was so good that the doctors who did the surgery asked him if he would agree to become part of a case study for publishing in medical journals and conventions and would give him free follow-up care for life if he consented. I have many stories like that, including an aunt who lives in Arizona who has an experimental cardiac procedure that needs to be done that can only be done at the Cleveland Clinic or at the Mayo Clinic. Brian, I implore you to do more research and find who and where in the country is known as the best for her condition and see them. When you say you are seeing "the best in the area" and you are still in Milwaukee... you need to expand your "area". One thing you are all correct in is that not all doctors are created equal; some have more expertise than others. And for God's sake, don't get an HMO that restricts who and when you can be seen for what. And if you do it is worth the additional out-of-pocket expense to go out-of-network to see the best specialist and pay for it because HMOs do not give you the best care, they give you the cheapest care and hope that it works. Hope that helps, and I hope you can find someone somewhere who can bring her back to normal.