Friday, March 13, 2009

Proposal to divert patients from the emergency room

Now this sounds like a plan to me. Why should the emergency room be burdened with those individuals who aren't in emergency condition? There ought to be a separate department to treat such patients instead of them having to register and wait awhile for an ER doctor.
University of Chicago President Robert Zimmer stepped into the fray Friday over a controversial proposal to redirect patients from the university hospital's emergency room, announcing steps to come up with "a better plan."

In an internal memo obtained by the Tribune, Zimmer said that a committee led by Dr. Everett Vokes, the newly appointed chair of the department of medicine, would "review, refine and modify" proposals initiated by the medical center's chief executive and dean of the medical school, Dr. Jim Madara.

"Fuller engagement of the faculty of the Department of Medicine should lead to a better plan and implementation," Zimmer wrote to faculty, residents and fellows.

Zimmer's memo comes as an intense debate has raged inside and outside the university after its announcement last month that it would eliminate beds in the ER and redirect some patients to other facilities in the face of spiraling costs and long waits for emergency treatment.
Questions also were raised by faculty – in particular the more than 400 doctors in the department of medicine, the school's largest group of physicians.

Inherent in much of the criticism were fears that the hospital was pulling back from its commitment to the surrounding area, which includes some of the poorest neighborhoods in the country. The Hyde Park hospital is the state's largest private provider for patients covered by Medicaid, a government-funded insurance program for the poor.

Zimmer's memo explicitly addressed those concerns: "We benefit from being part of these communities, and we have a corresponding obligation to contribute to their well-being."

Hospital officials have said that their emergency room was overrun with patients who didn't have true emergencies, costing the hospital tens of millions of dollars a year.

To help lower those costs, the medical center launched a program in 2005 to educate patients on the best use of the emergency room. Led at the time by Michelle Obama, the program grew into what is now called the Urban Health Initiative, run by one of President Barack Obama's closest friends, Dr. Eric Whitaker.

Last month, the hospital announced plans to expand the initiative by evaluating patients before care is provided and redirecting cases deemed non-urgent to other facilities. Almost immediately, the plan drew the ire of doctors and advocates inside and outside the hospital who were concerned that these patients might not get appropriate care.

For more than two years, Urban Health Initiative has been referring some patients to about two dozen health centers throughout the South Side or to Mercy Hospital and Medical Center, where the U. of C. moved certain psychiatric patients and some patients in need of general care such as treatment for acute heart failure.
What say you? Should there be a reform over who gets to be treated at an emergency room?

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