Would you expect to pay a penalty for using the emergency room if it turned out that you didn’t really have an emergency? The Journal of the American Medical Association released a study late Tuesday which demonstrated that such penalties can’t possibly be fair.
Dr. Maria Raven, an assistant professor of emergency medicine at the University of California, San Francisco, along with her colleagues, reviewed the results of almost 35,000 emergency room visits in 2009. They discovered that people don’t go to the ER to fool around — only about 6 percent of the visits could have been handled just as well in a doctor’s office. And those 6 percent had the same symptoms as the overwhelming majority of other patients, 89 percent, who visited the ER with conditions or injuries that turned out to be serious.
The classic example of a dangerous condition often confused with a minor complaint is chest pain, which could be a life-threatening heart attack or just an annoying case of bad heartburn.
For years, heart foundations around the world have been fighting a battle to get people to go to the emergency room if they have chest pain. You can see one of those campaigns in a video from the Irish Heart Foundation below. The trouble is that you’re probably not a doctor and you don’t even play one on TV. If you have chest pain, you are not qualified to guess whether or not you’re having a heart attack.
The American Heart Association doesn’t mince words: “Most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.”
Dr. Raven has stated that if a person has chest pain, “the only reasonable thing to do” is to get to the emergency room. Penalizing the patient or the ER if it turns out all he had was heartburn doesn’t make sense.
Yet there’s a growing movement to punish patients who turn out not to be as sick as they thought. A bill is now before the Nevada State legislature that would charge Medicaid patients a fee if they turned out to have a condition that could have been treated by a primary care physician.
Newton Medical Center in Covington, GA announced last fall that they would start charging patients a $150 fee if they didn’t have a “true” emergency. I’m not sure how individuals who don’t have medical training are supposed to know whether they have a “true” emergency or not, do you?
In my opinion, doctors go to school a heckuva long time to figure out how to correctly diagnose an illness. You and I aren’t going to be able to figure it out during an attack of severe pain.
Emergency room penalties might be more than unfair. If they stop someone having a heart attack from calling 911, they could kill.
[photo emergency room courtesy U.S. Army and Army Sgt. Jeremy Campbell]