I'm an M4 possibly going into EM, this is just something I have been thinking about on my rotation.
Yes, the purpose of the ED is to get the ball rolling by immediate recognition, evaluation, care, stabilization, and dispo of patients with acute illness and injury.
But the reality is that 30-50% of what comes into EDs is more primary care type stuff with uninsured patients. Wouldn't it be beneficial for EM docs to also have as good a grasp as FP/IM docs on primary care issues that are routinely seen? (HTN management, diabetes meds and other common chronic management issues )
Obviously the ER is not meant to be a primary care clinic, but for better or worse, it functionally is used that way for a large patient population who doesn't have insurance or patients who don't care/realize that they don't have a real emergency. And most of these patients likely won't ever follow up with a PCP to deal with the underlying issues going on, and will continue to burden the system with more ER visits that rack up thousands of dollars in health care costs. So why not add more of a one-stop shop component to EDs. My logic is that training EM docs for like a year in primary care IM/FP stuff (either in addition to or in lieu of some other rotation months) could allow them to and have a really large impact on the health care savings in terms of less ER visits from patients and less acute emergencies from uncontrolled medical problems. Thoughts?
Yes, the purpose of the ED is to get the ball rolling by immediate recognition, evaluation, care, stabilization, and dispo of patients with acute illness and injury.
But the reality is that 30-50% of what comes into EDs is more primary care type stuff with uninsured patients. Wouldn't it be beneficial for EM docs to also have as good a grasp as FP/IM docs on primary care issues that are routinely seen? (HTN management, diabetes meds and other common chronic management issues )
Obviously the ER is not meant to be a primary care clinic, but for better or worse, it functionally is used that way for a large patient population who doesn't have insurance or patients who don't care/realize that they don't have a real emergency. And most of these patients likely won't ever follow up with a PCP to deal with the underlying issues going on, and will continue to burden the system with more ER visits that rack up thousands of dollars in health care costs. So why not add more of a one-stop shop component to EDs. My logic is that training EM docs for like a year in primary care IM/FP stuff (either in addition to or in lieu of some other rotation months) could allow them to and have a really large impact on the health care savings in terms of less ER visits from patients and less acute emergencies from uncontrolled medical problems. Thoughts?