ACEP Cautions San Diego County Emergency Patients

Press Release:

The American College of Emergency Physicians (ACEP) along with its California Chapter today voiced concerns about warning people not to seek emergency care unless it’s a “true” emergency.

“Emergency physicians educate patients on the best places to seek the care they need,” said Jay Kaplan, MD, FACEP, president of ACEP.  We never tell people ‘not to go,’ to the emergency department because it’s not always possible for them to know when symptoms reflect a ‘true’ emergency.   For example, is my leg broken, or is it severely strained?  It’s not always possible for a patient to know unless he or she gets a medical examination. In addition, some patients, with conditions such as shortness of breath or indigestion, make the mistake of delaying seeking medical care when they are truly having an emergency. San Diego’srecent campaign may discourage some people from visiting the emergency department who really should be there and that would be tragic.”

Dr. Kaplan said emergency physicians have long advocated for making the determination of whether or not emergency care is appropriate should be based on patient symptoms, not the final diagnosis. The California ACEP Chapter sponsored legislation which was signed into law in California in 1994 protecting patients’ right to access the emergency department whenever they felt they were having an emergency.  The national prudent layperson standard was enacted by Congress in 1997 and is part of the Patient Protection and Affordable Care Act (ACA).

In addition, many people still do not have access to patient-centered medical homes and as a consequence, turn to the emergency department for care. Nearly three-quarters (71 percent) of emergency physicians responding to a poll in 2015 said they treated patients every day who ended up in the ER after first seeking help in an urgent care that was not equipped to care for them. More than half (54 percent) of emergency physicians say urgent care centers are marketing themselves as alternatives to the emergency department.

“Despite the ACA and the expansion of Medi-Cal, many patients are having trouble finding physicians willing to take their insurance,” said Dr. Kaplan.  “Emergency visits will continue to increase for many reasons including the nation’s growing elderly population and primary care physician shortages. The emergency department is the only place people can get help any time of day or night.  It’s an incredibly valuable service that we all need to support.”

California ACEP president, Dr. Marc Futernick, a practicing emergency physician in Los Angeles agreed. “I treat patients in the emergency department every shift who couldn’t access a primary care physician and had no choice but to come to the emergency department for treatment because their condition worsened dramatically.”

According to a report from the Center for Studying Health System Change (HCS), many assessments of “unnecessary” use of emergency care incorrectly look at patients’ diagnoses, instead of patients’ symptoms and why they are choosing to seek emergency care.  A study conducted by HSC in 2012 found that most emergency visits by Medicaid patients were for urgent or more serious symptoms. A study published in the Journal of the American Medical Association (JAMA) in 2013 found that most patients with so-called “primary care treatable” diagnoses come to the emergency department with identical symptoms to patients with true emergencies.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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