Overuse of the emergency room ultimately leads to higher health care costs for everyone.

Emergency room care costs about six times more than the same care delivered in the physician's office...

is it an emergency, or...?

When a health need arises, patients are often unsure who to call first.

by Tony Romano
 
A surprising number of emergency room visits aren't really necessary.

In 2002, almost 115 million visits were made to hospital emergency rooms (ERs), according to the American College of Emergency Physicians. Further, statistics show a dramatic rise in the number of visits during the five years after 1997, when there were only about 97 million visits. Emergency room care costs about six times more than the same care delivered in the physician’s office, according to physician billing firms. To cut down on expensive ER use, many health plans are raising ER copayments, providing hotlines staffed by nurses and urging primary care doctors to be more accessible.

Why do so many patients go to the emergency room?

Quite often people are unsure about what to do, and other times people simply don’t want to make or wait for an appointment. Some patients say they can’t get in to see their doctor the same day. The National Committee for Quality Assurance reports that in 1999, just under 12 percent of patients got appointments for the day they called. Primary care physicians (PCPs) said most patients don’t require a same-day appointment for many of the events that precipitate an ER visit. PCPs insist they usually can schedule patients who believe they are in a medical emergency on the same day.

Some health plans have a requirement for PCP availability, and some physicians maintain extended evening and weekend hours. For this reason, it is a good idea to call your PCP first before heading out to the ER. There are urgent care centers with extended hours in the unlikely event that your PCP is not available at the time of your injury or emergency.

 
When is it appropriate to go to the ER?

It is appropriate to go to the ER if you have a true emergency medical condition that requires immediate attention. Such conditions may be life threatening and can include trauma, prolonged vomiting, trouble breathing, a broken bone, chest pain (in some cases) or any other severe condition. In such cases, swift action of an ER is necessary either to treat the condition or relieve suffering from painful symptoms. A delay in treating a true emergency medical condition could mean risking permanent damage to the patient’s health.

 
What about Urgent Care?

If a medical condition is not life threatening, contact your PCP. If he or she is not available, then you should contact an urgent care center for advice or an appointment. As a precaution, you can ask your PCP about their availability for urgent care, so you’ll know before such an event occurs.

 
Remember your regular family physician

As a rule of thumb, you should call and see your regular physician whenever a new (nonemergency) medical condition occurs. Your PCP is the doctor who has the most contact with you, has your medical records available and can understand the new condition in the context of your previous medical history. With an unnecessary trip to the ER your regular physician misses that episode of care, creating a gap in the doctor-patient relationship which is so vital to your long-term care from your PCP. Moreover, overuse of the emergency room ultimately leads to higher health care costs for everyone. It slows down the ER system for those who have actual life-and-death emergencies, and therefore could even cost some lives. Overuse of the ER system is not good for anyone.

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