Nathan Lanier: Solving the emergency room crisis

The following is a reader take by Nathan Lanier.

I am not an expert on health care and I don’t pretend to be. What I am is an avid observer of emergency care.

My view is not without experience. The issues with my health aren’t important. What is important is that they land me in the ED far more often than I’d like. I can confidently say that my use of the ED is needed. However, some observers without all of the facts may accuse me of abusing a broken system.

I see a lot of overcrowding and can’t help but wonder why. Here are a few thoughts.

One idea is that medical records are not easily transferred among hospitals, which inevitably leads to repeat diagnostics and unnecessary rises in costs. It is imperative for the medical community, insurance companies, government, and patients to ensure that state-of-the-art systems to transfer medical records seamlessly are integrated in all hospitals. The cost of failing to do so is far greater than the upfront cost such a system will need.

Another point is that there is nothing to depress patients from abusing the ED. I think this stems from a fear that hospitals and doctors will be seen as insensitive if they attempt to shun the bad apples from showing up night after night at the ED.

A simple idea is that if a patient shows up, say, four times for the same thing and is sent home with the same medication and the same diagnosis, that person should have to pay regardless of their ability to pay. However, if upon examination of a non-insured patient something is discovered, the visit should be comped. These rules would bring true emergencies to the forefront.

You may be wondering: “What about the patients who truly need emergency care, but stay home because they are afraid of ‘paying the consequences?'” I answer that with a question of my own. What if the patients abusing ambulance services and emergency services weren’t there to distract resources from true emergencies? The amount of abusing patients negatively affected by such measures would be far less than the number of lives saved by keeping them home.

Such measures would not only benefit the patient, but the overall cost of health care as well.

There’s no denying that the growing misuse of EDs is a dire health care issue, but the problem can be fixed. It calls for radical thinking. What we need is bravery on behalf of hospital management and government officials not to be afraid to stand up for the citizens and patients who are most in need of urgent care.

Our future well-being just might depend on it.

Nathan Lanier blogs at


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