We address a common misconception, even elicited by former President Barack Obama, that increasing health insurance coverage would ultimately reduce emergency department visits.
Many Americans, even politicians, complain that people go to the emergency department unnecessarily. Perhaps it isn’t our fault as emergency physicians. It isn’t the fault of patients, either, for not knowing where is the “right” place to seek care. Instead, maybe we should look at the incentives our current system provides for the delivery of health care to better understand this phenomenon.
It continually amazes me that un- or under-insured patients must come to our public hospital, via the emergency department, for something as simple as orthopedic follow-up after being diagnosed elsewhere with a broken arm or leg—emergency departments being the only place beholden to EMTALA. We see them, take off their splint, and repeat the X-rays, then the orthopedics resident puts on a new splint and we schedule them for a clinic visit. It’s duplicative and inefficient.