Public education best way to cut unneeded ER visits

July 15, 2012 

Misuse of emergency rooms is a nationwide problem that one local team is attempting to curb.

The group includes clinics, doctors, health insurance providers, fire departments, educators, the United Way and Tri-City hospitals.

Together, they hope to combat the abuse of the emergency room for health concerns that are far from emergencies.

Last year, more than 3,000 people in our community went to the emergency room for common cough and cold symptoms. Those are the kind of ailments a primary care doctor or a walk-in clinic ought to treat.

But many folks are inclined to use the emergency room instead. That taxes the system and distracts highly trained emergency physicians from what they're there to do -- take care of folks with urgent medical matters.

The new group's aim is to direct patients to more appropriate places for their medical care. They'll help connect people with primary care doctors, who are able to provide better care in most cases.

Except in true emergencies, a family doctor who has on ongoing relationship with the patient and a thorough knowledge of his or her medical history is the better choice.

Of course, people with true emergencies, who are experiencing stroke or heart attack symptoms, should not hesitate to call an ambulance for a trip to the emergency room.

"This is not about keeping people away (from the ER)," said Richland Fire Chief Grant Baynes. "It is about getting them to the right place."

Baynes knows firsthand the volume of folks calling 911 who are not suffering actual medical emergencies. Medical calls account for about 80 percent of Tri-City fire departments' work.

"We will get things like, 'My finger hurts. I didn't do anything to it. I just woke up today and it hurt,' " he said.

Pasco's fire chief says he's gotten calls from people who are at the emergency room but think the wait time is too long. So, they called the fire department to pick them up from the public entrance to the emergency room in an ambulance and wheel them in the back entrance on a gurney to receive immediate care.

You might jump to the conclusion that the folks who use the emergency room like a walk-in clinic don't have insurance or fall into the low-income demographic. But the group has discovered that a number of people with commercial insurance often use the emergency room for nonemergency issues.

Part of the problem is access to care. Urgent care centers close in the evening, leaving no alternative for someone with an issue overnight. A shortage of primary care doctors is also an issue. It can be a challenge to find a doctor, and people may get frustrated by the process and leave their care to the emergency rooms.

Addicts also abuse the emergency room. These drug-seekers will go from ER to ER hoping to score prescriptions for pain killers. The three Tri-City hospitals are working together to track emergency room visitors and identify those who travel between them looking for narcotics. A grant is helping to pay for that monitoring system.

They also be identifying and counseling patients who use the emergency room when another alternative could provide better care. A similar program in Spokane has significantly reduced the number of unnecessary emergency room visits.

Education is the key to retraining the way people seek medical care. The group is conducting surveys -- available online at www.bfcha.org -- and distributing materials that help people know what kind of resources are available in the community and when to use an emergency room vs. a visit to a doctor's office.

The group has a big job ahead, but we're hoping they can help restore our emergency rooms and fire departments to their true roles of dealing with crises and not common colds.

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