How much unnecessary testing goes on in the ER?


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?”

er tests

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)