Nonurgent Emergency-Department Care: Analysis of Parent and Primary Physician Perspectives

David C. Brousseau; Mark R. Nimmer; Nichole L. Yunk; Ann B. Nattinger; Ann Greer

doi:10.1542/peds.2010-1723

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Non-urgent emergency- department care
Simon P. Ros M.D.

Published on: 05 February 2011

Published on: (5 February 2011)

Non-urgent emergency- department care
Simon P. Ros M.D., Director, Pediatric emergency medicine
As a long time pediatric emergency department physician I read the article about emergency department use by non- urgent patients with great interest.The findings of this study confirm my long term observation that "neither parents nor primary care physicians saw nonurgent emergency- department visits as a significant enough problem to warrant any change in physician care practices or parent care- seeking behavior." While...
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As a long time pediatric emergency department physician I read the article about emergency department use by non- urgent patients with great interest.The findings of this study confirm my long term observation that "neither parents nor primary care physicians saw nonurgent emergency- department visits as a significant enough problem to warrant any change in physician care practices or parent care- seeking behavior." While I fully understand parental attitudes and motivations behind their actions, I am amazed by the fact that our primary care colleagues ignore the impact of non-urgent patients on emergency departments ability to evaluate and manage urgent and emergent patients. There is simply no healthcare system in the world capable of taking care of all non-urgent, urgent, and emergency patients in a timely fashion in the emergency departments.The resources in the emergency departments are limited and diverting these resources to non-urgent patients jeopardizes the quality of care for our sickest patients.The non-urgent patients can and should be taken care of in other facilities ( urgent care centers, PCP offices, etc) which should extend their hours and increase their resources in order to provide parents with " immediate reassurance that their children are safe from harm". As an old board certified pediatrician I consider abdication of the responsibility for non-urgent acutely sick patients as a further erosion of general pediatricians' role(see neonatologists, hospitalists, etc ) and fear the day when third party payers decide that a practice limited to providing anticipatory guidance and immunizations does not require medical school education and can be delegated to nurse practitioners and other healthcare providers.
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None declared
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Competing Interests: None declared.