As hospitals across the country try to reduce overcrowding in emergency departments, one way to shift patients to a different but more appropriate setting is to identify and understand the types of patients who seek unnecessary emergency care.
Lena Wen, M.D., an emergency physician at George Washington University, writes in Slate that these patients often complain about long wait times at ERs because they don't understand that staff must treat the most critically ill patients first. She classifies patients into 10 categories in an effort to help understand them--and help them understand themselves.
Here are five of the most common types of patients that Wen says show up at the ED:
- Repeat visitors: Patients who continue to come to the ER for treatment of a chronic, ongoing complaint. ER staff must treat acute pain, but should also recommend that these patients see their primary care physician for ongoing medical problems.
- Patients who want a second opinion: These patients aren't satisfied with the diagnosis they received from their primary care doctor and specialists. ER staff should acknowledge their concerns, but explain that ERs have limited time and resources and can't possibly provide the in-depth exam necessary to identify the cause of their symptoms. Again, send them to their primary care physician, who can coordinate referrals and further testing.
- Internet surfers: Although the Internet is a powerful tool, it often causes anxiety in patients, who then come to the ER convinced they have a life-threatening illness. Recommend that patients use the Internet to help understand their diagnosis and treatment but not to diagnose themselves.
- Patients with multiple symptoms: This group of patients will answer "yes" to every question ER staff ask. Although there are some illnesses that affect many parts of the body, most of these patients just want to convince clinicians they are ill. But these patients often lead ERs to conduct unnecessary tests. Encourage these patients to be honest about their symptoms so they can receive appropriate care.
- Pill takers: These patients want narcotic medications and will tell ER staff they can't get a hold of their primary care doctor or someone stole their pills. Due to the rise in prescription drug abuse, ER staff must now become detectives in order to identify patients in real pain who do need medication.
To learn more:
- read Wen's column