National Physicians’ Group Gives ERs a Low Grade - News - @

National Physicians’ Group Gives ERs a Low Grade

Healthcare law is expected to create a surge of patients that will be hard to handle


CAROLINE CHEN, Bloomberg News | | Friday, January 17, 2014

With Obamacare bearing down on them, a doctors' group said emergency rooms are less able to provide quality care, and more resources will be needed to handle an expected surge of patients from the new law.

Hospitals have fewer beds available, causing delays in ERs that saw visits climb to 130 million in 2010, according to a report from the Dallas-based American College of Emergency Physicians. Federal funding for disaster preparedness has fallen, so the hospitals are also less prepared to handle a sudden influx of injured patients, the group said.

"This report card is sounding an alarm," Alex Rosenau, the physicians' group president, said in a conference call Thursday. "The need for emergency care is increasing, the role of emergency care is expanding, and this report card is saying that the policies are failing."

Care will become harder to access as people newly enrolled in the U.S. Medicaid program for the poor and aging baby boomers turn to ERs for medical services, said the report, which gave the nation's emergency care a grade of D+.

Reality Hits

The U.S. Patient Protection and Affordable Care Act broadens Medicaid eligibility to more than 19 million people. A study published in Science this month found new Medicaid patients in Oregon visited ERs 40 percent more often than the uninsured.

"Every year, it's a little worse," said Arthur Kellermann, dean of the medical school at the Uniformed Services University of Health Sciences in Bethesda, Md. "But unless you find yourself in a stretcher in a hallway without a bed, you don't realize it."

Staffed inpatient beds fell 16 percent from 2009 to 330 per 100,000 people in 2012, and psychiatric care beds dropped 15 percent to 26 beds per 100,000, the group said.

"Emergency department crowding is a direct result of inpatient capacity," said Jon Mark Hirshon, associate professor at the University of Maryland School of Medicine in Baltimore, who headed the report's task force.

ER physicians "have to spend a lot of time finding a place to send somebody," he said in a telephone interview.

The number of emergency physicians per 100,000 people rose to 13.5 from 11.8, the doctors' group said. That's not enough, Kellermann said in a telephone interview.

"ERs provide 28 percent of all acute care visits, but only 4 percent of doctors work in the emergency department," he said, citing a 2010 study published in the journal Health Affairs.

"If there's more people coming into the ER without a dramatic expansion in doctors and inpatient capacity, you'll get a bottleneck."

Kellermann, who previously headed the Department of Emergency Medicine at Emory University in Atlanta, said access is declining faster in low-income communities.

Hospitals are also less prepared for disasters, the report said, due to decreased federal funding, which fell 31 percent to $9.52 per capita from $13.82 in 2009.

"Times are not wonderful for a lot of hospitals: Volumes have been declining the number of paying heads in the bed, and money is tight," said Sheryl Skolnick, an analyst at Stamford, Conn.-based CRT Capital Group LLC.

Emergency Drills

The National Hospital Preparedness Program, which provides grants to hospital and health-care systems, "has been very successful at the hospital level and has evolved steadily to become a critical component of community resilience, enhancing the response capabilities of our nation's health-care systems," said director David Marcozzi in an email. Marcozzi didn't respond to questions about future funding plans.

The report found a wide range in the number of emergency drills conducted from state to state. Mississippi averaged 0.1 drills per hospital, while Rhode Island averaged 18.8.

"Where you're going to start cutting corners first is in disaster preparedness, because the tyranny of the urgent trumps preparing for the more downstream events," Kellermann said.

Doctors at Brigham and Women's Hospital in Boston, which treated 31 victims of the Boston Marathon bombing last April, practice disaster response procedures repeatedly, said Eric Goralnick, the center's medical director of emergency preparedness.

"The first several minutes are the most critical during a response," Goralnick said. "Drills are critical so your muscle memory will just kick in."

The doctors' report contained a range of recommendations, including: funds for a commission to investigate the shortage of health professionals and for pilot programs to improve care; doctors should be given some liability protection for ER work; and, federal money should be withheld from states that don't pass safety legislation like motorcycle helmet requirements.

Mobile Category: 

Copyright © 2013 LexisNexis, a division of Reed Elsevier Inc. All rights reserved. Terms and Conditions | Privacy Policy

Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News, hospital, emergency room, quality, Affordable Healthcare Act

What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

FEBRUARY 25-28, 2015

Baltimore Convention Center
Baltimore, Maryland USA






Get JEMS in Your Inbox


Fire EMS Blogs

Blogger Browser

Today's Featured Posts


EMS Airway Clinic

Innovation & Advancement

This is the seventh year of the EMS 10 Innovators in EMS program, jointly sponsored by Physio-Control and JEMS.
More >

Multimedia Thumb

Wesleyan Students Hospitalized for Overdose

11 students transported to local hospitals.
Watch It >

Multimedia Thumb

Denver Medic's Family Says Job Stress Contributed to Suicide

Veteran of over 25 years took her own life after a call.
Watch It >

Multimedia Thumb

Denver First Responders Join to Remember Paramedic

Veteran medic took her own life after fatal accident.
Watch It >

Multimedia Thumb

22nd Anniversary of WTC Bombing

Remembering the first terror attack.
More >

Multimedia Thumb

Hands On March 2015

Here’s a look at this month’s product hands on.
More >

Multimedia Thumb

15 Injured in New Jersey Explosion

Blast captured on dash cam during Stafford Township gas leak.
More >

Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >

Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >

Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >

Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >

More Product Videos >