Most ER Patients Are Insured, Study Says

From the LA Times, referencing a study by ACEP:

Challenging a common notion that uninsured patients are clogging hospital emergency rooms, a new study has found that the vast majority of adults who turn up there frequently have health insurance and regular doctors.

The finding suggests that expanding health coverage will not by itself significantly help emergency rooms cope with demands that include patients seeking care for routine problems such as colds or sinus infections, experts said.

The uninsured account for just 15% of emergency-room visits, according to the study to be published today by the American College of Emergency Physicians. The nonprofit organization advocates for the interests of emergency-room doctors and supports medical research.

Emergency rooms are crowded because they fill up with patients who cannot get in to see their own doctor or are waiting for regular hospital beds, experts said.

“We’ve cut hospital budgets so much, the only way they can be efficient is by operating as close to capacity as possible, like airlines,” said Sandra Schneider, head of the emergency medicine department at the University of Rochester in New York.

The study confirms earlier findings that have begun to change scholarly thinking about the cause of emergency room crowding.

Healthcare providers assumed until recently that uninsured patients were the primary cause of crowding, said Diane Jacobsen, a director at the Institute for Healthcare Improvement in Cambridge, Mass., who did not participate in the study. Most doctors are free to turn away patients who cannot pay, but emergency-room doctors must see everyone.

Over the years, however, research has indicated that the problem is broader and more complex. “We often focus on the ER as the problem, when the ER is a symptom of the problem,” Jacobsen said.

Course Educates Docs on Malpractice Issues

From the Seattle Post-Intelligencer via Symtym

Except for a crop of gray hair, the enrollees in Sean Byrne’s malpractice course at the University of Richmond Law School look like normal students. They sip Starbucks coffee and tap out notes on their laptop keyboards. And with lumpy hair and bleary eyes, a few looked like they rolled out of bed after a few hours of sleep.

But instead of suffering the effects of late-night study, some of them might have come off a long night at a hospital. That is because more than half the students are physicians, many of them in obstetrics or other specialties at high risk for malpractice lawsuits. Some have been sued; others say it’s only a matter of time.

“I’m shocked at what is part of my life that nobody ever taught me about,” said Dr. Shannon Weatherford, an obstetrician in Richmond who is taking the Saturdays-only class. “Four years of medical school and four years of residency, and there’s nothing about the business of medicine and the legal aspects. This is just a single, terrific opportunity to get educated on something I should know about.”

Much of the interest in the course was sparked by soaring premiums and growing insurance losses from malpractice claims that have led to calls for tort reform (though some critics have accused insurers of overstating these losses).