- Wastes gazillions of dollars
- Loss of productivity by confining folks who should be working
- Departure from sound medical practice which diminished the profession
- Emotional costs to the individuals and their families
- Unnecessary exposure to the risks of hospital life
How can this runaway train be brought under control? First, let’s try a little tort reform. Second, pay a flat rate for an ER visit. Under this model, if the ER physician orders an MRI on a patient with a back strain, the hospital swallows the cost. Finally, when hospitals are penalized financially for hospitalizing folks who should have been sent home, we will witness the miracle of a runaway train performing a U-turn on the tracks.
While the Rand Corporation’s results are not earth shaking on its face, my intuition, insider’s knowledge and a tincture of cynicism all converge on the conclusion that for too many patients the ER has become a portal of entry in the hospital. Is the greater good served if the ER is a revolving door or barricade?