>What’s the problem?
>Across the EM blogosphere, there has been quite a lot of annoyance as of late about people clogging up the ED with frustrating complaints of runny noses, refills for blood pressure medication etc etc. The general consensus seems to be, and it seems obvious to us, that these are the type of things you need to go to your primary care doctor for.
So why don’t these people go to their primary care doctor? What is the barrier? So I tried a little experiment myself to attempt to find an answer, I decided to try and see a primary care doctor (as I’d been meaning to go anyways for the past few months and kept putting it off). When we ask our patients why they didn’t got to their primary doctor for this, there is a common list of reasons
Excuse #1; I don’t know what number to call.
1. I figure that most of these “frustrating” patients may not have easy internet access, so I didn’t allow myself to use a computer in finding a number to call. However, very few people don’t have phones where you can’t connect to the internet, so I did not restrict phone internet use. A quick google for “[Hospital Name] family doctory” got me a phone number which I called. As an alternative, I also called information and quickly got connected to the appointment hotline for the hospital. While taking less than 3 minutes, this was probably the hardest step of the whole process
Excuse #2: They had no appointments
2. Lies! I know for a fact this group unfreezes appointment slots monthly, weekly and then daily. I got a NEW PATIENT appointment for the next morning when I called.
Excuse #3: I had to wait for ever to see the doctor/ I don’t have time
Did you actually show up on time? Did you have to wait longer than the 4 hours you did here in the ED? I showed up right on time, had my paper work completed and was registered within 10 minuets of showing up, had vitals taken with 15, was roomed within 20, and had been seen by the doctor within 22 minutes. Was on my way out the door within 40. Not bad. Certainly far less than the 4-8 hours you are spending in the ED.
Excuse #4: It’s too had to get to.
Its a block and half from the ED. If you can get to one, you can get to the other.
Excuse #5: Its too expensive.
Actually, its cheaper, for both you and the health system in general. I can’t cite any numbers per se, other than I know my copay for a visit to my primary is 80% less than my copay for an ER visit.
So where does the problem lie here? At least here in my neck of the woods, its cheaper, easier and less time consuming to go to your primary care doctor than it is to come to the ER for something simple, something that really should be seen by your primary. So the hurdles that people commonly site as keeping them from seeing their primary care doctor, don’t actually exists, at least in my little experiment here (granted, with an n of 1).
When these people do come in to been in the ED, I’d rather do more than just bitch about it in a blog post. And I did this little experiment with that in mind. How can I do my part to help educate people, steer them down the right track? Any ideas?