Much of the ongoing health care reform debate has focused on unnecessary health care expenses—specifically, medical bills that rack up without demonstrably improving peoples' health. According to Peter Orszag, the director of the federal Office of Management and Budget, about $700 billion, or 5 percent of the U.S. gross domestic product, is wasted on unnecessary care, such as extra costs related to medical errors, defensive medicine, and just plain fraud. At the center of this discussion are “unnecessary” ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors' offices. If we could only convince patients to take their stubbed toes to urgent-care clinics or primary-care offices instead of ERs, the thinking goes, we could save a load and help fix this whole health care fiasco.
But there are a few problems with this logic. …
It’s a well-written, short article.
He makes some good points, and (being an EM doc) I happen to agree with most, specifically that a lot of money is spent in medicine on procedures of uncertain (at best) benefit.
The fix is probably correct, too, though I don’t see Americans jumping on changing their sedentary, easy lifestyles. (That includes me).
Are you actively working with your EMS system to provide their Paramedics and EMTs with options other than transport to an ER for patient disposition? It varies but in many systems the patient has to either refuse treatment or be transported to an ER and a EMT would be really sticking their neck out to suggest transport by private auto to an urgent care clinic. Google “EMS 2.0” to and you will discover a discussion in social media that includes alternative destinations for ambulance transports and more patient dispo options for pre-hospital care providers.