Emergency Medicine on Life Support

As we know, Emergency Medicine in the United States is in critical condition. Over-worked, under-paid, and under appreciated. Ambulances are turned away, patients are left waiting for hours and sometimes days. When they are finally seen internal pressure like lack of staffing combined with bonus structure such as RVU, makes getting these patients through as quickly as possible the priority vs. real patient-care. The result? Mistakes, Claims.... Patients and families left unhappy, suffering and physicians feeling like nothing can be done. What about reimbursement, overcrowding and lack of specialtists when they are needed most?
EMS, Specialtists and Emergency Physicians need to work as a team, Congress needs to ensure all emergency rooms are properly equipped and ready to handle whatever comes through the door. In 2003, emergency departments saw nearly 114 million patients - a 26 percent increase over the previous decade - but during the same 10 years the United States lost 703 hospitals and 425 emergency departments, one report noted.
Emergency departments are also playing key roles in disaster response, but in 2002 and 2003, emergency medical services received just 4 percent of the $3.38 billion doled out for emergency preparedness by the U.S. Department of Homeland Security.The reports urges Congress to allocate $50 million to reimburse hospitals for uncompensated emergency and trauma care and to increase funding to provide hospitals with resources needed to handle disaster situations.
Uninsured patients use the emergency departments as if they are walk-in clinics. With over 47 million uninsured people in the United States, where are they supposed to go? Instead of putting out these daily fires in the ED, we have got to create long-term solutions.

ED Quality News

Texans approved Proposition 12, a constitutional amendment that protects that state's tort reform legislation from judicial reversal. The amendment gave the Legislature the constitutional authority to set limits on damages in medical malpractice and other lawsuits. This has important ramifications for emergency physicians and emergency departments state-wide.
According to the Houston Chronicle, Prop. 12 "would remove a likely legal challenge to the constitutionality of a recently enacted civil justice law capping noneconomic damages for pain and suffering in medical malpractice lawsuits. It also would clear the way for the Legislature in future sessions to limit damages in other types of lawsuits."
"Proposition 12 represented an epic struggle between doctors and plaintiffs' lawyers. More than $13 million was spent on advertising. Most of the $7 million spent in opposition to the measure came from wealthy personal injury trial lawyers."
Governor Rick Perry said, "...today Texans have taken an important step toward protecting both the practice of medicine and Texans' access to quality health care."
Lt. Gov. David Dewhurst stated, "The people of Texas have voted to limit frivolous lawsuits, and families will now have greater access to affordable health care."
State Rep. Joe Nixon, R-Houston, who sponsored Prop. 12, said, "The Legislature went to work for the citizens of the state of Texas to ensure adequate access for health care. It looks like right now that the citizens have supported our efforts on their behalf."
Pain and Suffering Caps:
Injured patients may still collect unlimited real or economic damages, which includes all lost past, present and future wages and medical costs. However, the amendment caps the subjective noneconomic damages at a maximum of $750,000 for pain and suffering, emotional distress and loss of consortium. Only $250,000 of the noneconomic damages could come from physicians, $250,000 from a hospital or nursing home and $250,000 if a second facility is involved.
Premium Relief:
The state's largest medical malpractice insurer, Texas Medical Liability Trust, promised to reduce rates 12% in January, 2004 if the amendment passed.