How much unnecessary testing goes on in the ER?

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Plenty, if you ask the people most familiar with the situation, the emergency physicians themselves.

According to a survey from Emergency Physicians Monthly , many tests performed in the ER are deemed unnecessary to good patient care. Here’s how doctors responded to the following question: “Given that in a typical shift of eight hours you see an average of two patients per hour (16 patients/shift), could you have eliminated any of the following tests and/or treatments without compromising the quality of care? If so, how many of each?”

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As you can see, laboratory tests and CT scans comprised the greatest proportion of unnecessary tests. It’s been well-debated on this blog as to why, but one reason is that there’s a mentality that a wide net has to be cast, so that uncommon causes of a patient’s presentation aren’t missed.

The survey also found that non-economic caps are these physicians’ preferred choice of malpractice reform, with 84 percent of emergency physicians calling them a “non-negotiable part of health reform.” Politically, however, that’s unlikely to take hold.

What makes more sense is providing some sort of protection for doctors to adhere to evidence-based standards of care. If we can standardize the indications as to when specific tests are indicated, and reinforce them by linking them to malpractice protection, I think you’d see doctors taking less of a “shotgun” approach.

And when bending the cost curve is becoming a primary concern, that’s an important consideration. Especially when you consider that many ER physicians think they can save more than $500 per shift by removing unnecessary testing.

er money

(via WhiteCoat’s Call Room)

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