Had a conversation with a community practice ER physician yesterday which really reinforced my belief that in many states(not all) things need to change in terms of this....
Medical ER's are *not* the place for this to happen. Especially in community settings(which is what the vast majority of er's are in).
Emergency rooms, for the most part, have *nothing* to offer these patients. And they are horribly inefficient. And they take up space, beds, etc which are needed to treat medical emergencies....which is the concept behind the er.
It's a question of what is best for patients. It is not best for the typical SI patient to go to a community ER with a chief complaint of SI, wait around for 10 hours in an er room until the mental health caseworker comes by to assess the patient, then be sent to the hospitalist(!) at the same hospital because there are no beds at the regional state facility or any private psych hospital in the area(if they wuld have taken him) where he waits 3-4 more days on a medicine unit waiting for a bed to open up. The er attending(a nice guy) asks me "why does the initial process have to be done in my er? What about the er offers an advantage over the fire department, or a police department for example?"....
Medical ER's are *not* the place for this to happen. Especially in community settings(which is what the vast majority of er's are in).
Emergency rooms, for the most part, have *nothing* to offer these patients. And they are horribly inefficient. And they take up space, beds, etc which are needed to treat medical emergencies....which is the concept behind the er.
It's a question of what is best for patients. It is not best for the typical SI patient to go to a community ER with a chief complaint of SI, wait around for 10 hours in an er room until the mental health caseworker comes by to assess the patient, then be sent to the hospitalist(!) at the same hospital because there are no beds at the regional state facility or any private psych hospital in the area(if they wuld have taken him) where he waits 3-4 more days on a medicine unit waiting for a bed to open up. The er attending(a nice guy) asks me "why does the initial process have to be done in my er? What about the er offers an advantage over the fire department, or a police department for example?"....