Here’s an update on what’s happening over at the medical center in Galveston, Texas.
I’ve previously blogged about how Hurricane Ike devastated the University of Texas Medical Branch in Galveston, and its struggles in recovering.
Now, it appears that they’ve shut down their emergency department, and converted it to an urgent care center. There are several important ramifications to that action. First, urgent care centers do not have to see all comers, and can financially screen patients before treating them. Second, they are not equipped to deal with more severe cases, so patients are forced to call 911 to be transported 40+ miles to Houston.
As WhiteCoat comments, expect more hospitals to do this. You can only cut hospital payments so much before they are crushed by the financial burden of simply staying afloat. And there is a limit to vilifying hospitals for collecting from patients before realizing that if they don’t, they’ll simply shut down.
And where does that leave patients? With poor hospital access, and an hour-long trip simply to visit the emergency department.
Related posts:
- Are emergency physicians best served to staff urgent care centers?
- Should emergency departments handle more urgent care cases?
- A concierge ER, or, can EMTALA-free, cash-only emergency departments save hospitals?
- Emergency care
- Is rationing health care impossible in the United States?
- Did the University of Chicago sacrifice patient care for profit?
- Emergency departments are crowded and unsafe
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If physician reimbursements are cut any further, then no will be in the ER to service those patients anyway.
Kevin, didn’t you blog yesterday that er’s shouldn’t be doing this because cutting down er’s is poor quality care.
Chicago I believe.
Are you trying to present both sides?
I love that some professionals viewed the move with “disgust” and that some patients were angry about it. Both of these reactions stem from the idea that the business side of medicine should never play a part in decision-making. In addition, there is the sense, on the part of patients, that the world somehow ‘owes’ it to them to have an emergency room, no matter how poorly it is doing financially.
Both physicians (and I am one) and patients must learn that medicine is a business, albeit one that is severely hampered by our current rules and financing system. The sooner we realize that capitalism cannot solve the problem when it is not allowed to exist, the sooner we can try to remove barriers to care and allow people to solve problems AND make a profit.
Trying to achieve quality, affordable, and compassionate care by any other means (including government supplied health care) is simply a pipe dream.
(BTW, I noticed that one of the comments was that perhaps anyone can call themselves an urgent care center – even if they are a full-scale ER. I wonder if this would be the appropriate move for other ERs.)
This all comes back to government meddling. EMTALA needs to go. Draconian rules about balance billing for medicare and insurance contracts the prohibit giving discounted fees to cash paying customers needs to end, too. And sadly what will people demand for a solution? An expansion of the entitity that put us here in the first place.
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