American College of Emergency Physicians | News Room - Published Letters

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No Substitute for the ER 

Chad Masters’ guest commentary in the Naples Daily News promoting urgent care centers over emergency departments is both inaccurate and dangerous.

Contrary to Master’s assertions, the Centers for Disease Control and Prevention report that just 4 percent of all emergency patients have non-urgent problems. Masters stands to profit from increased patient numbers at urgent care centers, but spreading misinformation that nearly all emergency patients can be safely treated there is reckless and irresponsible.

Urgent care centers provide a great alternative source of medical care for patients who cannot see their primary care physician in a timely fashion for minor problems such as pink eye, sprained ankles and minor burns. But they are not a substitute for the emergency department.

The prudent layperson standard, which is part of federal law, says that symptoms -- not diagnoses -- determine the appropriateness of an emergency room visit. Patients lack the training to determine what is and isn’t an emergency and there is approximately a 90 percent overlap in symptoms between problems that are emergencies and problems that aren’t. 

Chest pain is a classic example: it might be indigestion or it might be a heart attack. Wasting time in the wrong place can lead to lifelong disability or even death, especially for conditions that are extremely time sensitive such as heart attack and stroke. Emergency physicians treat patients every single day who started at urgent care with problems that were too serious to be treated there and then ended up in the emergency department.

Promote urgent care for what it actually can do, which is deliver care conveniently for minor problems. And make sure that patients having the symptoms of an emergency go to the emergency department, where they belong.

Rebecca Parker, M.D., FACEP; president, American College of Emergency Physicians, Washington