ACEP Chief: ER Docs Must Look Beyond Acute Care

Cheryl Clark, for HealthLeaders Media , October 17, 2011

Emergency department doctors also should "enhance our observation units to further reduce readmissions and potentially avoid admissions, and develop better disease management and palliative care protocols," Seaberg said.

Meanwhile, these acute care frontline providers are also fighting what they consider to be erroneous perceptions ? that once healthcare reform is implemented patients who now go to emergency rooms seeking care will instead go to their primary physicians. That's not what happened in Massachusetts, and it isn't what will happen when healthcare reform coverage expansions take effect, he said, pointing to several research papers being presented during this forum.

Emergency physicians believe that primary care physicians ? even if there are enough around to see all the patients seeking care ? will still tell their patients to go to the emergency room, especially if it is after hours, when more than two-thirds of the 136 million ED visits occur.

Many doctors attending said they are already starting to do just what Seaberg suggests, even in a low-cost utilization area of Iowa City.

Hans House, MD, associate professor of the Department of Emergency Medicine at the University of Iowa Hospitals & Clinics, said that his emergency department ? as opposed to the hospital ? has already started to hire nurse managers and other care coordinators to visit patients and make calls to assure they and their families are getting appropriate care.

"We're pleased, because it's very well-received," he said.

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