You need to have some blood work
done so you call your primary care
physician. You’re told there is an opening in two weeks but you’re not sure if
you want to wait that long. Is it better to go
to the emergency room and have the test
done that day or wait the two weeks and
see your doctor?
“In respect to how we spend health care
dollars, use of emergency rooms inflates
the rate of health care expense in the
United States,” says Dr. Scott Felten, director of the emergency department of the
new Akron General Health and Wellness
Center North in Stow. “The emergency
room costs more than traditional health
Smart Business asked Felten how
employees can make the best choice when
deciding where to go for treatment.
How can managers direct their employees to
efficiently use the emergency room?
There are some benefits to seeing a primary care doctor as opposed to the emergency room. You need to explain why it’s
beneficial to do so.
Number one, this may be the first and
only time the doctor in the emergency
room will meet you and treat you. Many
individuals have chronic medical problems
that need to be addressed by a regular
medical doctor. Or you may be on a lot of
medications and have a reaction or other
complications if there is a change to your
medication. So the benefit of seeking care
through your primary medical doctor is
that he or she knows you. Primary care
physicians know your medical problems
and your history and they can follow up
with you more closely than someone in the
Number two, although you may have to
wait for an appointment, that appointment
is yours. When you go to the emergency
room you may have to wait several hours
to be seen, depending on how busy it is.
Because there are more people seeking
treatment than there are beds or capacity
available, the emergency department in the
U.S. is overwhelmed. Part of the reason we
decided to open the new facility is to take
some of the load off of the Akron General
Why are emergency departments so overwhelmed?
Emergency care is an expensive aspect
of the health care dollar. Under the Federal
Emergency Medical Treatment and Active
Labor Act, anybody who goes to the emergency room must receive at a minimum a
medical screening examination, regardless
of ability to pay. Some individuals cannot
pay even a portion of their bill, yet costs are
incurred in providing treatment to every
single patient. There’s a cost to the hospital
for supplies, to the doctors for malpractice
insurance, a nursing staff, a tech staff. If
patients don’t pay their bills, it creates a
deficit of health care dollars. A regular doctor has the option of not treating a patient
if he or she doesn’t have insurance or cannot pay.
So by their very nature, emergency
departments lose money because of their
operating deficit. We’ve suffered tremendous cutbacks in actual compensation
from insurance companies. The deficits
arise because of multiple factors. For some
hospitals, the financial burden is so great
they have to shut down, increasing the volume at other hospitals and putting them at
financial risk. It’s a cycle.
How else does use of the emergency room
affect health care rates?
Tests, X-rays and laboratory work all cost
more when done through the emergency
department based on the fact that they’re
emergent. If someone has to have blood
tests done at his or her doctor’s office, it
will be less expensive than having it done
at the emergency department. It will cost
less to the health care system, the insurance companies, and to Medicare and
Do you see less use of the emergency room
In my 10 years of experience in emergency department medicine, people seem
more likely to come to the emergency
department because the American culture
seems to be geared toward ‘I want it now’
and the emergency department serves that
If I call my doctor’s office, I may be told I
need to make an appointment and that I
can get in in two or three weeks. With the
emergency department, I can go any time
that’s convenient for me. I can go at 7 a.m.,
9 at night or 3 in the morning.
We continue to encourage managers to
advise employeees to see primary care
physicians unless it is truly an emergency.
DR. SCOTT FELTEN is director of the emergency department at
the new Akron General Health and Wellness Center North in Stow.
Reach him at (330) 344-6326 or [email protected].