Not Enough Primary Care Access?
Here is the heading from the the AAFP e-newsletter:
Increase in ED use may be linked to lack of primary care access
It comes from an article in the Yakima Herald and continues with this amazing discovery:
Washington state data show hospital emergency department visits increased 16% over two years, which aligns with a trend seen nationwide since the Affordable Care Act expanded insurance coverage. Yakima Valley Memorial Hospital vice president Diana Patterson said the higher ED use stems from having more insured adults and a lack of access to primary care.
Did anyone NOT see that coming? No incentives to create FP jobs. PCPs quitting right and left. We all knew it was a mess and yet these idiots point it out as if it was startling. It would be laughable if it wasn’t so sad.
What..what…what…what? Who would have predicted that the generation kill of family physicians would result in a problem of access and increasing visits St Elsewhere? It’s astounding! 95% of the doctors I served with during my residency have left family medicine forever. Devalued family physicians driven into other specialities and careers to escape the primary care death spiral. Better hire more mid levels , administrators and/or increase the fast track hours in the ED. Don’t create/hire more primary care doctors. Never mind the so called “quality of care” of these alternatives. This system is broken beyond repair. Look up clusterf&*k. This is what happens when insurance companies, government, and hospitals run healthcare. It should be about the doctor and the patient. Morons.
I certainly hope they had a nice fat grant to demonstrate what is obvious to anybody who actually sees patients in the ER.
And it keeps giving, folks. The horror is not that the ER utilization is up a tick. That could be tweaked by some beancounters who do such things. When they discover what lies beneath, perhaps they will get it – perhaps not.
There are no hospitals anymore, not like there used to be. I will see patients who need a brief course of IV antibiotics for a possible pneumonia, painful pancreatitis, a flare of a familiar pattern of ulcerative colitis. In the ancient days, I would admit them to the hospital to control their symptoms, and bring them back out when they and I could manage their care at their home.
There is no way to admit a patient to the hospital. EVERYTHING goes to the ER. One can call Dr. duJour on the Hospitalist service, and offer her/him extra work for no extra pay – or choose to defer the patient to the ER, to get picked up on the next shift under prefab orders. Guess which.
Or sent home. A few bags of Solu-Medrol and IV antibiotics and a nitro, and GTG. It’s not just that the process is inefficient and inhuman. ER’s are simply urgent care/mini hospitals attached to a building that is a Potemkin Village, containing a 10-bed ICU at three floors of administrators. Since decreasing hospital admissions and length-of-stay has been a concept interpretable by bean counters everywhere, and has been pushed for 30 years, the best hospital turns out to be one which is not used. So it ain’t.
DPC can save billions of dollars over this busted and pathetic shamcare operation. Ideally, a hospital is just a place for more intense treatment and observation. Instead, you have red-eyed moonlighters in the ER with no access to patient records (great job, EMR!) and no idea what to do for the patient. (Great Job, hospitalist movement!) The ER is becoming a place with bright lights where nature can take its course.
In my home state, I opened the paper to see: State Medicaid costs called a ‘runaway train’
Guess which state I live in. Give up? You’re right! One of the Nifty Fifty where the bureaucrats were running around with extra-strong sacks to catch all the dough raining down on them.
For all you (former?) ACA supporters that follow this blog, and you KNOW who you are, for those of you who thought that the fix for health care was more government, remember: the ACA did not create a single new doctor, nurse, or hospital bed. All it created was new need.
A few of us predicted this very outcome, but “we had to do something…”
Oh but wait, I thought the ACA was supposed to fix all that…