, Gloucester, MA

January 25, 2013

Think twice about some ER visits

On the Mend
Joe DiVincenzo

---- — One hundred thirty-six million – that’s the number of times Americans visited their local emergency room last year.

But that shouldn’t surprise you. With an estimated 300,000,000 people living in this country, going to the ER is as routine a process for some as bringing a newborn to a pediatrician’s office for regular checkups.

It’s a costly service, however, and it’s largely due to the gross misuse of the primary function of an ER – emergent medicine. At an average of $500 per visit, things such as a lingering cold, mild stomach irritation or refilling a medication over the weekend when your doctor’s office is closed, are dramatically increasing the cost of providing medical care — and raising your premiums.

Staffing an emergency department is an expensive endeavor — so expensive that ERs around the country are shutting their doors — like a giant retail chain going out of business, closing dozens of locations per year.

Hopefully you won’t need urgent medical services anytime in the next year (or any years following), but if you do, here are some things you should know prior to checking in.

The average co-payment for an ER visit is $150 — all of which you will be held responsible for — even if no services are provided other than an interview and a vital signs check. That amount may not break the bank for most people, but it might make you wonder if your problem is truly of an urgent nature. By the way, the average co-payment for a visit to your primary care doctor is $25 or less.

The ER is a great place to pick up a strain of drug-resistant bacteria capable of colonizing throughout your body and weakening your immune system. The high-traffic nature of an emergency department ensures that these various, tough-to-kill micro organisms (which are found on most hospital surfaces) are readily available for transmission — especially in the waiting room where you’ll be spending an average of 60 minutes before seeing a doctor.

One out of every 50 patients visit the ER specifically for illicit drug use — and this is particularly true of the late-night crowd. If it means bringing small children with you, weigh just how urgent it is that you check in. Hopefully it can wait until the morning when your primary care office is open.

Emergency staff are trained in emergent medicine. Generally speaking, they are not expert practitioners in orthopedics, cardiology, pulmonology or any other medical subspecialty. If you have a rare or unusual problem, going to the ER will likely not furnish the solutions you seek — and you’ll be out more than a hundred bucks.

The primary role of an emergent practitioner is to stabilize your condition and help control pain. While intravenous fluids and pain agents are prescribed frequently to manage an urgent case, the scope of practice for these clinicians generally does not extend much beyond the doors of the emergency room itself. So if you’re aiming to restock a supply of medication, guess again. It’s not likely that you’ll get more than a two- or three-day supply — just enough to float you until you can see your primary care provider.

Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes “On the Mend” weekly. Questions may be submitted by email to