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Health & Science

Emergency Docs Fear ER Crowding Could Get Worse Under Health Reform

The national health reform law could help millions of uninsured Americans get health coverage. But critics say the law neglected to address the question of where all those newly insured Americans will go. A survey of emergency physicians released today shows they are nervous about ER’S becoming even more crowded than they already are. Carrie Feibel has more.


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Dr. Arlo Weltge works in the emergency rooms of Memorial Hermann Hospital and LBJ General Hospital. He is also an officer with the American College of Emergency Physicians, which released the survey today.

“Right now as we sit here today there is a very stressed system, with not a lot of reserve.”

Visits to emergency departments in Harris County topped 1.1 million in 2008, according to a study by UT’s School of Public Health here in Houston. About 40 percent of those ER visits were for illnesses that could have been treated outside the hospital by a primary care doctor.

As Weltge explains it, the crowding in the ER is the visible symptom of an invisible problem: not enough doctors doing primary care for the coughs, fevers and ear infections that drive people to emergency departments. And as more people get insured under the new law, that problem could get worse before it gets better.

“As patients have access and get insurance to care, when there is no available primary care resource to take care of them, that oftentimes will lead to an increase in ED visits.”

Weltge says the federal government now needs to address the primary care shortage by stabilizing Medicare payments, and creating more community clinics. Until that happens, ERs will continue to be crowded with patients who have nowhere to go.

For more information about the survey by the American College of Emergency Physicians, visit

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