Texas Emergency Medicine Report Card: We’re only failing half!

The National Report Card on the State of Emergency Medicine came out a couple of days ago, and I finally got around to looking at mine today.

Hmm, a C.  I guess I’ll have to get someone to sign mine before I take it back…

Despite receiving solid marks for its Quality and Patient Safety Environment and having one of the best Medical Liability Environments in the country, Texas continues to face significant problems, particularly in the area of Access to Emergency Care.Txreportcard

Strengths. Texas has the third lowest average malpractice award payment in the nation ($148,495), reflecting the multitude of medical liability reforms that have been enacted…

Challenges. Access to Emergency Care in Texas is in crisis. The state has the highest rates of uninsured children and adults (21.2 and 25.8 percent, respectively), and ranks among the lowest states regarding access to all types of providers…

Frankly, if they don’t grade on a curve nobody’s going to do well on this test.

See your state’s results here.

Update: symtym has pictures for the whole US.  They’re not pretty.


  1. How does insurance status have anything to do with access to emergency care?

  2. Seriously.

    Have you ever said, “Sorry Pedro; no insurance, no appendectomy!”

    Or “Since you don’t have insurance, that laceration will just have to heal on it’s own.”

    ACEP sucks.

  3. Scalpel is right. If uninsurance affects access, why did I write off $10 million to indigent/charity care this year (much of it emanating from the ER)?

  4. My guess for an answer (while not defending the ACEP methodology):

    Uninsured = less likely to pay for care -> more ED bad debt -> fewer resources to buy equipment/hire nurses -> longer waits and a disincentive to care.

    Ultimately, this is ACEP’s strategy to get attention (and money) out of legislators at every level. Maybe ACEP should ask for a bailout: ED’s are Too Big to Fail!

  5. Well I guess someone has to be last. WooPigSooee go Arkansas! It really doesn’t seem as bad here as ACEP depicts. Even though there are no “designated” trauma centers there is no lack of transferring pts to our hospital (a larger private referral center) and to the University Hospital. We have a trauma system plan already drawn up, but have been waiting on the politicians to fund it. Maybe this year?
    One thing for sure, we have nowhere to go but up…

  6. This has little to do with care and more to do with how much insurers pay out. I guess kudos to Texas for being good to malpractice insurers based on some sketchy evidence?

  7. On a good note for Texas – at least it’s ranked ahead of Oklahoma in something according to national surveys!