People having a heart attack, a stroke, or suffering from severe wounds after an accident go to the hospital emergency room. But what about people who want a prescription refill or think they might have a sinus infection? Believe it or not, a large number of those patients go to the ER too.
Emergency Care for All
In 1986 Congress passed the Emergency Medical Treatment and Labor Act, which requires hospitals to treat any and all patients who arrive at their emergency department, regardless of their ability to pay and are suffering from an actual emergency. Likewise, most localities, require their ambulances to transport patients to the nearest emergency room, regardless of the patient’s ability to pay or whether it appears they’re dealing with an immediate medical need.
Around one-fourth of emergency department visits are considered unnecessary, according to the Agency for Healthcare Research and Quality adding up to more than $4 billion each year. Those visits are also one of the most expensive ways to receive medical care, averaging $2,500. That’s a heavy financial burden for patients and their insurance providers. When bills go unpaid, the hospital generally absorbs the cost and tries to recoup that money in other ways, such as from other hospital patients, who are often shocked to see exorbitant charges, like $8 for a single aspirin, on their hospital bill.
Not Enough Access to Primary Care Doctors
Treatment for things like a cough, a sore throat, or an ear infection call for primary care, not emergency care. However, far too many people, especially those in under-served areas, don’t have access to a primary care physician, also known as a general practitioner, a family doctor, or a “regular” doctor, and therefore seek primary care in the emergency room because they feel they have nowhere else to go.
Dr. Alan Lindemann M.D., a physician who has been practicing medicine in rural North Dakota for four decades told CBN News people using the emergency department for non-emergencies is, “a real problem, and it’s getting to be a bigger problem all the time.”
He says people living in sparsely populated areas like his often don’t have access to a primary care doctor.
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“People, unfortunately, use the emergency room for default care,” he said, “The patients can’t get care any other way.”
It’s not just country folks, people living in underprivileged urban areas, particularly those who have no transportation, also find themselves with little access to a primary care physician.
Working Towards a Solution
Some medical providers, like Sentara Health Care, are working towards a solution.
“We need to take our care and put it in the areas of need,” Dr. Michael Charles, executive medical director of the Sentara Community Care program told CBN News.
The primary care physician now sees patients in a number of Sentara health clinics in underserved areas, including one inside Norfolk, Virginia’s The Union Mission Ministries, a Christian homeless shelter. In the five months since the clinic has been located within the shelter, unnecessary trips to the emergency room have dropped a whopping 80 percent.
“It was interesting,” the administrators here said, ‘You know, I’m not hearing the ambulances come as much. I used to hear the ambulances just about every afternoon coming by here and I’m not hearing that as much.'”
Fewer unnecessary ER visits allow hospital staff to focus more on life-threatening issues.
“Emergency rooms are very busy,” said Dr. Charles, “They’re there to take care of the people who have accidents. If you have chest pain or trouble breathing that’s where you need to go.”
While easing that pressure is a positive benefit, Union Mission Ministries chief operations officer Rev. William Crawley told CBN News reducing unnecessary E.R. visits isn’t the main reason the ministry provides care.
“I believe it’s our Christian mandate, we believe it’s our Christian resolve to meet people where they are, to love our neighbor as we love ourselves,” he said, “And as we consider ourselves, and how we want to be attended to and want to have the fullness of health, why wouldn’t we want that for our fellow neighbor?”
In addition to the doctor’s office inside the homeless shelter, Sentara has also opened a permanent primary care clinic in a nearby underprivileged neighborhood. The medical provider also regularly drives recreational vehicles that have been converted into doctor’s offices to other under-served areas. Although updated data isn’t available, it’s likely these efforts will have a greater impact on reducing the number of people going to the ER for primary care.
Read: Eliminating ‘Medical Deserts’: Christian Ministry Partners with Health Care System to Reach Under-Served Populations
More Primary Care Reduces Overall Health Care Cost
Health care experts say the more people regularly see a primary care physician, the greater the overall savings on health care expenditures.
“If somebody has a sinus infection and they’re seen in a doctor’s office, a primary care office, the cost of that visit to both the patient as a co-pay and to the health care system is a lot less than if that same patient went to the emergency room for a sinus infection,” said Dr. Charles.
Short-term savings are only part of the picture. In the long run, people who get routine medical checkups with their primary care physician, are far more likely to prevent an expensive, catastrophic health problem down the road than those who don’t normally seek preventative care from a doctor.
“If we’re controlling their diabetes, if we’re controlling their blood pressure,” said Dr. Charles, “Then they’re not going to end up on dialysis from their diabetes. They’re not going to have a stroke because their blood pressure is out of control.”
If this new model can change the long tradition of requiring patients to either find a doctor or go to the emergency room, there’s potential for a major positive impact. By putting family physicians closer to the people, better one-on-one treatment can happen and E.R.s can go back to quickly providing true emergency care.
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