ER Wait Times Are at an All-Time High – It’s Never Been a Better Time to Switch to DPC
A recent article in the Journal of Health Affairs highlighted the growing wait times for Emergency Rooms across the nation, as well as the growing rate of abandonment, where patients leave the ER before being treated. It’s been making some news. It has folks concerned.
This has been chalked up to several issues. While the nursing shortage was exacerbated with the Covid pandemic, this trend in ERs has been increasing since 2012. Others have pointed to the expansion of Medicaid, which does not financially incentivize its recipients to seek primary care during typical clinic hours. Instead, it’s more convenient for those recipients to wait until they need to be seen and then go to the ER where care is free for them. Additionally, because no one is turned away from the ER, the increase in illegal immigrants seeking care in ERs has been a contributor. Although some have advocated for increasing Medicaid for this population as a potential solution, California has been doing this for years and they have some of the worst ER wait times and abandonment rates. Lastly, some observe that large hospitals and healthcare organizations have been co-opting rural assistance by buying up smaller rural hospitals to take advantage of special programs and subsidies for those hospitals. The larger hospitals then take advantage of those programs and subsidies but decrease services in some of the rural hospitals.
Of course, there is increasing burnout among our ER colleagues. Private equity takeovers have exacerbated this problem. It’s to the point where Family Medicine physician Dr. Sara Pastoor wrote this opinion piece in Stat, warning about the dangers of burned out ER Medicine physicians leaving to set up DPC practices, despite their lack of primary care training.
What does this mean for trained primary care physicians (Family Medicine, Internal Medicine, Med/Peds, Pediatrics), besides that some other specialties now want to be us? It means there will be growing interest from patients and employers to seek DPC. Actuarial reports have already shown that DPC reduces UC and ER visits (as well as improve health in several other ways). Folks will continue to catch on. The first ever National DPC day is fast approaching on November 1st, spreading the word about the benefits of DPC. Now, more than ever, is the time to make your switch. There are lots of good resources available to help you: books, webinars, conferences, and a national organization, the DPC Alliance. Let’s continue to help reduce ER wait times and abandonment rates by providing even more great DPC.
The wait times are high as they are DPA and uninsured who suck the tax dollars out of the rest of us. Hardly candidates that can afford DPC as they need the money for beer and cigarettes. Setup a DPC practice in the “wrong” geographical area (ie. poor people) and I guarantee they will go bankrupt. PERIOD! One needs to be cognizant of the demographics where one wants to do DPC or risk going broke. In rural areas, docs do it all. Hospital, office practice and take call. Doubt many DPC docs do that. Hey, it’s nice work if you can get it but it won’t work everywhere.