Recently, an article was published regarding Emergency Room Medical bills. The author wanted to evaluate how unpredictable and costly ER bills were across the country. The article discussed the lack of transparency from hospitals regarding the cost of medical services. While there were several points made relative to the financial aspect of healthcare, I would like to offer a counter viewpoint. I have worked with Emergency Room Physicians for over twenty years and would like to point out several key elements of Emergency Department access.
Emergency Departments treat everyone who walks through the door before asking if they have the ability to pay. Emergency Departments are staffed to handle the healthcare emergencies of their community twenty-four hours a day, 365 days a year. There are times they have few or no patients, they are still required to be staffed to a level to provide a safety net for the community. The unfortunate truth is that patients are put in predicaments when treated by out-of-network physicians during a visit to an in-network facility. Unfortunately, insurance companies deal with physician groups with a heavy hand and these groups are forced to go out-of-network to receive fair compensation for the risk and work involved in treating their patients. According to the Henry J Kaiser Family Foundation, in 2017 the United States had about 28 million people that did not have health insurance. There are few options for the uninsured: Pay up front at an Urgent or Primary Care Center or visit an Emergency Department where they will be treated without question and billed for treatment later. In the thirty plus years that I have worked in this industry.
While I agree with the article that our healthcare system forces many patients into unfortunate circumstances. It’s important to remember that many hospitals and physicians are struggling with their finances as well. Articles daily reflect the strains on healthcare systems; a Morgan Stanley report last August revealed that when analyzing data from roughly 6,000 hospitals; 10% of those hospitals were “weak” based on criteria for margins for earnings before interest and other items, occupancy and revenue, according to Bloomberg. The analysis further revealed that another 450 hospitals were at risk of potential closure. The financial strain is real for hospitals, emergency departments, physicians and patients alike.
In my experience, working and meeting with thousands of physicians over the years, their motivation is simple, to make a difference by taking care of patients. These same individuals undergo high-stress environments daily and with increased risk to their personal safety. In a recent press release by ACEP, nearly half (47 percent) of emergency physicians report having been physically assaulted while at work. Sixty percent of those same physicians confirming those assaults occurred in the past year.
While it’s easy to try to quickly find a point to blame; it’s important to understand the entire picture, which in the case of healthcare, is complex. There are many factors which influence healthcare from technologies and innovations to people and organizational structures to patients and satisfaction to financial management. Taking a holistic approach to finding the best solutions takes people working together. Emergency Departments continue to be valuable resources to our communities across the nation. Let’s take a minute to recognize their benefits and continue to look at opportunities which create winning scenarios for our physicians, our patients and our communities.