Panda’s back, and wonders why people with good insurance still go to the ER. The answer is simple:
So you see, Emergency Medicine is a victim of it’s own success and, as Emergency Departments begin to look more and more like self-contained hospitals-within-hospitals complete with admitted patients (waiting for rooms, you understand) and even critical care patients being managed for most of the initial five or six hours in which everything important is usually done, the problem of overcrowding is only likely to get worse. Add to this the growing reluctance of office-based practices to handle really complicated patients when it is ridiculously easy to divert them to the Emergency Department and a steadily worsening shortage of primary care physicians, while the situation is no doubt great for my personal job security it is hardly the best way to do business.
Related posts:
- Emergency department overcrowding
- Doctor shopping
- Emergency care
- Interruptions when doctors see patients and how that affects care
- Emergency room specialist call
- Why would a doctor stop seeing patients?
- Neuropathic pain education; Paul Krugman wins Nobel; Vasectomy pain; Paying to stop smoking; Health care isn’t free
KevinMD.com on Facebook
{ 3 comments }
What does this say about the “If you subsidize something, you get more of it” explanation?
So this phenomena is not the inevtiable consequence of the socialists giving poor people Medicaid/SCHIP coverage?
I am so confused. Did Michael Moore do this?
The problem is that we are a terrifically over-doctored society which now does not have enough doctors, mid-levels, and nurses to go around. Not everything is an urgent medical problem…except that people believe it to be. Many of the problems we see are actually lifestyle problems more than anything else, as in, “Mr. Smith, your back hurts because you weigh 400 pounds and there’s really not much more we can do for you unless you lose weight.”
Or, “Mrs. Jones, you are on home oxygen because you smoked a pack a day for fifty years and, as you still insist on smoking there is no way you are ever going to feel better.”
And we do still get a lot of freeloaders in our ED, that is, people who could afford to pay for a doctor’s visit or even insurance but don’t because we do, in fact, encourage inappropriate use of Emergency Services by giving them a way for free to everyone with no questions or even a co-pay required.
But as to the original point, subsidizing free care in the ED through EMTALA (or actually not subsidizing it directly but instead making everybody with insurance soak up a piece of it)causes everyone, including primary care physicians, to take more of it in classic economic behaviour.
Well-insured patients go to the ER because ER’s aim their adverstising towards them- “Fast-track” programs are aimed at well-insured patients with minor problems.
Comments on this entry are closed.