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- Nov 27, 2002
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Let me make an argument that will be unpopular with the wallets of Emergency Physicians:
By overutilizing the ED as the portal of hospital admission we as a society are wasting a lot of money. We would be better served if there were more direct admits. That would cut out the patients who really dont require the services of an ED or an EP.
How many times a day do most of us see patients sent from nursing homes, private physician offices or sent in after a phone conversation with a PMD with instructions Get this and that test and admit to my service? I see it a lot. At several of my hospitals, depending on the time of day, it can be around 50%.
Now Im not talking about the patients who actually need an ED work up. Hey! This guy in my office is cool, pale and diaphoretic. I calling 911 and sending him to you. Im not even talking about the patients who can go home if their work up is negative like the 20+ patients a day my group sees for rule out DVT (seriously, I have numbers).
The causes for this are multifactorial like most problems in medicine. Mainly though it boils down to physician laziness and stupid, wasteful insurance company mandates.
If these patients could bypass the ED and avoid the resultant bills I would make less money but resources of the system could be used more effectively.
By overutilizing the ED as the portal of hospital admission we as a society are wasting a lot of money. We would be better served if there were more direct admits. That would cut out the patients who really dont require the services of an ED or an EP.
How many times a day do most of us see patients sent from nursing homes, private physician offices or sent in after a phone conversation with a PMD with instructions Get this and that test and admit to my service? I see it a lot. At several of my hospitals, depending on the time of day, it can be around 50%.
Now Im not talking about the patients who actually need an ED work up. Hey! This guy in my office is cool, pale and diaphoretic. I calling 911 and sending him to you. Im not even talking about the patients who can go home if their work up is negative like the 20+ patients a day my group sees for rule out DVT (seriously, I have numbers).
The causes for this are multifactorial like most problems in medicine. Mainly though it boils down to physician laziness and stupid, wasteful insurance company mandates.
If these patients could bypass the ED and avoid the resultant bills I would make less money but resources of the system could be used more effectively.
