More than Two-Thirds of Emergency Physicians Expect ER Visits to Increase Despite National Health Care Reform

Health Insurance Coverage Does Not Equal Access To Medical Care

May 17, 2010, Washington, DC - More than two-thirds (71 percent) of emergency physicians responding to a poll expect emergency visits to increase, and nearly half (47 percent) predict conditions will worsen for emergency patients, despite the new health care reform law. The poll was conducted by the American College of Emergency Physicians (ACEP) from April 23 to April 30, 2010.

"The nation's emergency physicians absolutely support reforming our nation's health care system and expanding health insurance coverage to all Americans," said Dr. Angela Gardner, president of ACEP. "However, health insurance coverage does not equal access to medical care, especially with an aging population and physician shortages. You also can't prevent most emergencies."

More than two-thirds (71 percent) of 1,800 responding physicians expect emergency visits to increase despite the reforms, and more than half (54 percent) say the number of specialists willing to respond to calls from emergency departments, such as neurosurgeons and cardiologists, will decrease. In addition, more than half of the respondents (61 percent) don't believe the new law will effectively address uncompensated care, which has closed hundreds of emergency departments in America, most recently St. Vincent's in New York City.

Dr. Gardner said that St. Vincent's Hospital has been an icon of emergency care for 160 years, caring for many of the patients injured in the September 11th terrorist attacks, as well as those injured last year when US Airways made an emergency landing in the Hudson River. The loss of an emergency department in New York City will force patients to travel farther for care.

"If the Times Square bomber had actually blown up his car, injured victims able to walk would have found the doors of nearby St. Vincent's closed and locked," said Dr. Gardner. "Imagine being hurt and not knowing where to go for help. The need to shore up our nation's emergency departments is as urgent as ever."

Most emergency physicians (73 percent) report crowding in their emergency departments at least 3 or 4 days per week, with 23 percent reporting at least 5 days per week and 24 percent reporting every day. Nearly 30 percent say that crowded conditions have significantly worsened, and 36 percent say conditions had increased slightly.

ACEP conducted the poll from April 23 to April 30, 2010. E-mails were sent to 17,361 emergency physicians, and 1,822 responded. The survey has a theoretical sampling error range of ± 2.24%.

"America's emergency physicians are reminding national policymakers that the dangerous problems facing emergency patients are not going away," said Dr. Gardner. "There are several provisions in the legislation that may benefit emergency patients, such as inclusion of emergency services as part of any health insurance package, but many of the details still must be worked out through regulation. We are hopeful, but we fully expect emergency visits to increase, just as they have in Massachusetts since it implemented universal coverage three years ago."

"ACEP has worked with - and will continue to work with - members of Congress to find solutions to improve the safety and efficiency of emergency care for all Americans," said Dr. Gardner. "But this poll should send lawmakers a clear message that emergency departments, which are a critical, life-or-death part of our health care system, need help now. Everyone is only one step away from a medical emergency"

ACEP has been urging policymakers to focus on reducing uncompensated care in emergency departments and stopping the practice of "boarding" emergency patients, which the U.S. Government Accountability Office has identified as the primary cause of overcrowding. Boarding occurs when emergency patients who have been admitted to the hospital are held in the emergency room, waiting for hospital inpatient beds. It contributes to crowding because it reduces the emergency departments ability to care for additional patients.

"A permanent solution also must be found to fix the fundamentally flawed Medicare physician reimbursement formula," said Dr. Gardner. "The continued reliance on this defective system will force more and more physicians to limit the number of Medicare patients they see or cause them to stop participating in the Medicare program altogether. And where will these patients go? They will seek care in the nation's emergency departments."

ACEP is a national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.