ER overuse – “the crisis is near”:

The number of Central Florida hospital beds, meanwhile, has grown just 13.7 percent during that time, from 4,278 in 2000 to 4,865 last year. And even if there are empty hospital beds, there are not enough nurses and doctors to treat patients in those beds.

The issue is compounded further by the state’s medical malpractice insurance crisis, which has resulted in fewer high-risk specialty doctors such as neurosurgeons and obstetricians.

Other factors? There’s a growing number of uninsured Floridians who often go to ERs for routine health care, creating a backlog for everyone else; and the number of elderly residents — who tend to be sicker and become ill more often — also is skyrocketing. In addition, some people wind up in emergency rooms because their doctor sent them there, perhaps for a reason as simple as the fact that the doctor’s office lacks X-ray equipment.

I’d say the overuse crisis is already here. I’d also like to add defensive medicine is a leading factor.

For primary care physicians: sending people to the ER during off-hours to cover themselves from the risk of telephone medicine. It is much safer to say, “Go to the ER”, rather than risking giving medical advice over the phone.

For ER physicians: defensive admissions to cover themselves from any possible discharge complications. It is much safer to admit a chest pain, rather than risk missing an MI.

In other words, it’s all about spreading the malpractice risk around.