Emergency room staffs are seeing more primary care cases instead of emergencies because of fewer patients with insurance, leading to more costly care.
Dr. Tariq Sayyad, an emergency physician at Western Baptist Hospital, said his department takes all cases and considers each to be an emergency. The triage process determines if a condition is emergent requiring immediate treatment, or less so and requires services akin to primary care.
Sayyad said the community needs more primary care practitioners. Patients may grow frustrated with longer wait times at a doctor’s office. If a patient seeks treatment for a primary care condition like a cold, flu, upset stomach or mildly elevated blood pressure, Sayyad and other ER staff will provide treatment. People with more pressing cases will be seen immediately, while others may experience a wait.
Greg Kingston, a registered nurse at the Lourdes ER, said he’s seen a rise in primary care cases in his hospital because of the national economy. Many people lost insurance coverage when they lost jobs, or are underinsured. ERs provide treatment without asking a patient to provide insurance or demonstrate an ability to pay.
“Whenever a patient thinks he has an emergency, he needs treatment, whether that’s the emergency room or a clinic like Redicare. If a clinic requires payment up front and they are not insured, this may keep them from receiving treatment. The ER is an option. We are glad to provide care, but if a more emergent emergency case presents, then we are going to take care of this emergency, like a patient with chest pain, stroke symptoms or trauma,” Kingston said.
Kingston added those with serious emergencies will be seen at once. Those with less severe maladies may face longer waits. Time of day also can increase wait times with the greatest falling between 2 and 10 p.m. The national wait time for less acute cases may be between 3 and 3.5 hours, he said.
According to a news release from Melony Bray, director of marketing at Murray-Calloway County Hospital, a lack of medical records in the ER and unfamiliarity with patients and family history make diagnosis more difficult and take longer. Doctors need to order more tests, including lab work and X-rays. Without a thorough review, it may be harder for the staff to identify underlying conditions that caused the problem or other conditions threatening a patient’s health.
Bray said higher costs and less efficient care leads physicians and insurers to seek primary care in a clinic and leave ERs to patients with major injuries and serious medical conditions.
Sayyad said while his ER takes all patients, he may encourage some to seek a primary care clinic or a physician’s office if they continue to come for care. These alternatives are more cost effective, better treat patients and are less time consuming.
“Then there are some people that have come to see the department as a facility that provides their care and use it as their doctor’s office,” Sayyad said. “We let patients know they have other options that demand less time and money.”
Contact Alan Reed, a Paducah Sun staff writer, at 270-575-8658.
