What can we do to stop the over use and abuse of the Emergency Room?

Question

Everyday, we see people showing up in the ER with colds, hurt toes, very very minor things and get upset because the providers take care of the true emergencies-heart attacks, strokes, car wrecks etc. first. I don't think it takes a rocket scientist to figure out that there are only so many doctors to take care of patients and the worst ones WILL get seen first.
How is the best way to educate people it is better to go to a clinic than to the ER? AND educate them that if they show up with something minor they WILL have to wait a long time?

Answer 1

Use and abuse of ER services is commonplace.
The normal help seeking approach is usually misused by a lot of people. One reason is that it generally saves time for the care seeker, avoiding appointments and getting prompt attention even if it be for minor complaints.
On the other hand,some patients due to their perceptions of having a severe condition or impending catastrophe with fears of untimely death colored by family mishaps,watching popular soap operas,hearing from friends of medical afflictions,are prone to rush to the ER for re-assurance,ECG's, Oxygen ,intra-venous fluids etc

Public education by posters,clearly and concisely listing possible emergencies like severe injuries of burns, road traffic accidents,severe breathing difficulties,unstoppable bleedings etc.
An initial assessment followed by separation of genuine Emergencies from non -emergencies, a single dose for non emergency cases,after a suitable period of waiting so as to make it unattractive for the non emergency cases to frequent the ER, firmly but kindly after assessments to clearly indicate that their cases do not qualify for ER treatment .
Finally ,continuing efforts of educating the people by popular TV based commercials, Public hoardings,Community based orientations wherever possible.

ARE YOU MAKING IT DIFFICULT TO ATTEND TO A REALLY LIFE THREATING SITUATION OF A FELLOW HUMAN BEING BY YOUR COMMON COLD OR SPRAIN?

Well designed posters at the clinics of GP's,Hospital emergencies Pharmacies could really help.

Answer 2

First of all, you're blaming the wrong people. Those patients are in there because the overall healthcare system is broken. They are not in there because they don't know there is another option.

Family Doctors, Pediatricians, and Internal Medicine are normally the first line of defense. However, these doctors are most often by appointment only and require someone to be responsible for payment. They accept only certain insurance and often demand co-payment up front. The cost of insurance is unreachable by millions of American's, so they don't have any. This makes this first line of defense useless.

The Urgent Care facilities were created to be available without appointment. They should, in theory, work in concert with the primary care doctor. However, they too require the co-payments and insurance. And, their co-payment is often greater than the Primary care doctor. The Urgent Care issues are that they aren't very well integrated with flowing information back to the primary care doctors, they are ill-equipped for real emergencies, and they are rarely open 24/7.

The hospital, well at least most of them, cannot deny service and they are open 24/7. Yes, they are the most expensive. But, not to the person that can't afford anything. The hostipal is the only choice. So, they are miserable with the a sore arm, a limp that won't go away, heartburn from stress, a viral infection that they can't shake.... and they go to the Hospital. Where do YOU expect them to go?

Until our country collectively decides to take care of the ill like every other modern country in the world, we'll have poor people in the Emergency rooms seeing Doctors for ailments that should be handled with a Primary Care physician office visit.

Answer 3

I work in a hospital, and worked in an ER for about 2 years. Pepole aren't really educated about the Urgent Care facilities, and clinics until they actually get to the hospital, and the staff tells them that there is another place to go.

After Hurrican Katrina, my hospital was one that actually stayed functional in this area. We had an influx of patients because they had nowhere else to go. And with the wave of patients came the complaints from them too.
"Why did they get called before me? I've been here since 5 this morning."
All we could really say is, 'Ma'am/Sir, we have to go by severity of the patient at this time."
I felt so bad saying that to the patients, because I felt for them. I really did. But there was nothing we really could do.

The clinics and urgent care facilities, need to advertise more. One a few minutes away from the hospital put a billboard up and the patient flow has aleviated a little bit. We also have flyers in the hospital that we can give to patients, to let them know there are other facilities.

Answer 4

OK, so by the other answers we now know that people go to the ER because they don't have medical insurance and have just be billed.

You can stop over crowding by making sure people pay allllll of their hospital bills in an orderly fashion. This way, the Urgent Care clinics that are here to treat those running noses might start offering billing options or payment plans as well, instead of cash or insurance only.

How ya gonna do that?

Answer 5

People go to the ER because they have no place else to go. If people had access to health care for non-emergency issues, they'd go there instead of the ER. I bet ERs are much less abused in nations with universal health care.

But ERs do have triage nurses who determine who is in most urgent need, and they see those people first. If you show up at a crowded ER with a sore throat, be prepared to wait a long time!

Answer 6

We eh? My suggestion is for the heads of the hospitals, nationally, to have a summit meeting. The amount of money it costs these hospitals to provide medical intervention to the poor in their ER's will be the thrust of this meeting. When the total of the costs are totaled, the sum will be astounding. It is not without reason to believe that a health care plan can be developed which will provide benefits for those qualified. The cost for the provision of these services will be computed per state, and the government will provide half the cost of these services with the state.

Answer 7

These people who go to ER with minor problems probably don't have medical insurance.

The only real solution is health insurance for everybody.

Answer 8

People go with minor stuff because the ER has to treat them by law regardless of their ability to pay.

That's why you see every ER stuffed full of illegals with runny noses.

Answer 9

Sounds like it's time for you to move on to a different dept. The ER has been like this for years. That's just the way it is.

Answer 10

Some people are just very selfish and think that they are the only ones that matter. I suppose the only way to discourage them is to charge for non urgent matters.