Tuesday, September 7, 2010
Emergency Rooms Used for Routine Care
shows that more than a quarter of patients who currently visit emergency departments in the U.S. are there for routine care and not an emergency. New complaints like stomach pain, skin rashes, fever, chest pain, cough or for a flare up of a chronic condition should not be treated in emergency rooms. They are best worked up and treated by an Internist or Family Physician...preferably one who knows the patient.
Nationwide there is a shortage of primary care physicians and many have closed practices, limit Medicare patients and take no Medicaid at all. When a patient has stomach pain and is told the next available appointment is in 2 weeks, it is no wonder they head for the ED. Once there they will likely get a battery of tests that may not be needed and even Cat Scans before they are told to go home with a diagnosis of "gas".
The good thing about the Patient Protection Act is that millions of new people will get insurance of some type. The bad thing is, unless we address the primary care shortage in a real meaningful way, it may just lead to more expensive care in the Emergency Rooms across America.
Robin Weinick of the RAND Corporation and a coauthor of the study said that urgent care centers could potentially manage between 14-27% of all emergency department visits and save $4.4 billion - or .2% of national health care costs annually.
We need to expand the capacity and weekend hours at community health centers. We have already passed the window to increase the supply of primary care physicians by ignoring the crisis. But it is not too late to change the incentive structure for payment and try to lure more young doctors into primary care. It worked for Radiology and Anesthesiology and Urology. The nation would be the beneficiary.
Posted by Toni Brayer, MD at 12:01 AM