As ER visits climb, hospitals react

The Philadelphia Inquirer
March 16, 2001
by Stacey Burling

"Some experts say the emergency room is being transformed from a last recourse in desperate moments to a place where people can get all sorts of care at all hours."

"Rather than fighting the trend, some hospitals are accommodating the increased traffic by adding physicians' assistants and nurse practitioners to ER staffs and offering 'fast track' care."

Ted Christopher, ER director at Thomas Jefferson University Hospital:
"I think emergency medicine is probably misnamed. It should probably be named 24-hour-access care."

Uwe Reinhardt, Princeton University health economist:
"Using the emergency room for routine procedures is actually quite efficient."

Michael Carius, president-elect of the American College of Emergency Physicians:
"You can either try to change demand, or you can try to meet demand."

Comment: There is a great need for night and weekend clinical services. The emergency rooms are filling this role by default. Emergency room costs are high, in part because of the numbers of uninsured that resort to this source of care. Shunting the non-life threatening cases to more efficient care within the same facility improves the utilization of resources. In addition, if we were to adopt universal health insurance, we would end the cost-shifting that makes emergency services outrageously expensive for the rest of us.