Brought to you by the WSJ:
ER times dragged out 36% longer between 1997 and 2004, according to a Health Affairs study by a gaggle of Harvard docs out today. Researchers say there’s every reason to think the trend has worsened, thanks to the closing of some ERs and increased volume at the rest, the WSJ reports.
Like most of today’s health care problems, a lack of primary care access is the root of long ER waits. With sufficient PCP access, the burden on the ER will be significantly lightened, leaving them to focus on true medical emergencies.
Related posts:
- Doctors can’t wait to practice in Texas
- Wrong focus
- Suing the government for wait times
- My take: Mid-levels, PCP summit
- Why EDs are overcrowded
- Billed for a 19-hour ED wait
- Op-ed: Shortage of primary care threatens health care system
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In the article they imply that the rise is due to concomitant increase in uninsured.
As I mention over at the excellent PandaBearMD, wouldn’t mandates (careful, don’t read free healthcare here) help this problem by forcing people to purchase insurance?
Then they could go to their PCP instead of freeloading it at the ER.
Massachusetts has mandated insurance and a worsening primary care access problem. Insurance without access doesn’t do anything to solve this.
Interestingly our ER – in a small town about an hour North of NYC isn’t that overcrowded. At least when my mother was brought there by ambulance – she had aetrial febrillation, I didn’t see that many people waiting.
Now, that time she was brought up by ambulance, but there was one time she went there on a weekend – she had a bone stuck in her throat that was hurting, and her PCP office was closed, she didn’t have to wait that long.
I wonder if it is because the hospital is in a small town in a relatively expensive area… In NYC, a friend of mine had to wait three hours with severe abdominal pain that turned out to appendicitis.
Will retail pharmacy clinics help?
“Will retail pharmacy clinics help?”
Theoretically, yes. But then you get people like Zagreus Ammon having a cow because it puts patients at risk because they’re not having a doctor diagnose that ear infection or strep throat.
In reality, of course, his quarrel amounts to nothing more than turf protection. I’m pretty sure Flea was the only MD who didn’t have rectal-cranial issues when it came to retail clinics. Amusingly enough, most of Ammon’s stated problems with retail health clinics could just as easily be substituted with “the ED”. (Save the one where a real, live doctor sticks that otoscope in your ear, or depresses that tongue.)
Oh the horror.
Retail clinics are an imperfect solution. Although they may cater to the uninsured for non-emergent issues,they will not encourage identification/treatment or prevention of chronic problems, ie dm/htn/lipids/smoking/breast cancer screening/colon cancer screening (despite claims that they do). Health care costs are driven up not so much by the 40 year old healthy carpenter with a bronchitis (probably viral but urgicares/retail clinics will almost certainly prescribe zithromax reflexively) but by complications of chronic conditions. Plus, are reatil clinics willing to accept medicaid? I doubt it, so medicaid patients will still be getting care from the ER.
Turf issues aside, the motivation for retail clinics is monetary, plain and simple, not quality or access.
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