Quote from GDog7NYC
It's definitely an article that provokes a lot of thought as to the direction that Emergency Care is headed, but at the same time, it makes me think about a couple of things. I have a dedicated Minor/Urgent Care area in my ED that is open until midnight and that is staffed with an ED attending, a PA and 2 RNs. I think triaging out, like the article describes, defeats the purpose of having that area (as many ED's do). Also, we have a Walk-In Clinic directly across the ED that is open during business hours that our medical and surgical residents rotate through to provide continuity of care for many of our chronically ill patients. Are we still constantly overcrowded and inappropriately utilized? Of course. Part of the problem there is that many of the Attending Physicians with admitting priveleges in our hospital constantly tell their patients things like "well, if we want to get these tests done faster, go to the ER" or "if you can't get ahold of me, then just run over to the ER and we'll get you patched up" even if it's not a medical emergency. Many times, I can't help but feel like i'm treated like the 7 Eleven of the healthcare industry - cheap, open 24 hours and most convenient for all involved. Of course, many physicians who dont work in an ED fail to tell their patients how expensive it is be seen by us, particularly for non-urgent matters. I believe that if misuse of EDs is to be tackled, then there has to be a concerted effort between all medical disciplines who constantly view our departments as the paths of least resistance and thus advise their patients to "go there".
You make perfect sense with this post. I have had dr's tell me to go to the ER in the past as well. Now, my new dr. just tells me that if the pain I have gets excruciating, to call and leave her a message and she'll meet me there, but that's a different situation.
We used to go to the ER on weekends instead of calling the dr. because I didn't want to bother him. Can you imagine? I would NEVER, EVER do that now. Firstly, as you said, the ER is very expensive and secondly, it is my dr's job to be there when I need him (or someone in his practice).
I agree that it has to be a concerted effort from everyone involved to get these ER's used for what they are intended and not just as a 24 hr. "clinic".