The American College of Emergency Physicians recently published its 2014 Report Card documenting the state of emergency medical care in the United States. In 2009, the United States received a C- as a national grade, and that mark fell to a D+ in the most recent report.
The ACEP Report Card looks at many facets of emergency preparedness to formulate national and state grades. Some of the factors they examine include: Access to Emergency Care, Quality and Patient Safety Environment, Medical Liability Environment, Public Health and Injury Prevention, and Disaster Preparedness.
To understand why America received such poor marks, we sat down with Thomas Wyatt, President of the Minnesota Chapter of the American College Emergency Physicians. He was more than generous to answer our questions, which you can see below.
1. What do you believe is the main reason emergency medical care in the US received a D+ national grade on the recent ACEP report card?
It’s multifactorial, but the bottom line is that there is an increasing demand for emergency services, but we have fewer resources available to provide those services. For example, from 1995-2010, ER visits increased by 34% and at the same time the number of ERs decreased by 11%. Our emergency care system is under great stress.
2. How can individual states, as well as the nation as a whole, improve their grade?
This Report Card should serve as a wake up call and a call to action for our state and national legislators to make it a priority to strengthen the nation’s emergency care system. New laws need to be enacted in order to address all categories of the Report Card, and ACEP stands ready to collaborate with any lawmaker to help develop legislation.
3. What would you like to see lawmakers and politicians do to help reverse this trend?
As stated, lawmakers need to enact legislation, such as Rep. Dan Schoen’s (DFL-MN) Trauma Bill, which would fund trauma centers, EMS and emergency preparedness training in an innovative way. Politicians also need to address other key areas of the Report Card, such as the medico-legal environment, more funding for disaster preparedness, and injury prevention.
4. Of the five metrics that make up a state’s overall grade, (Access to Emergency Care, Quality and Patient Safety Environment, Medical Liability Environment, Public Health and Injury Prevention, Disaster Preparedness) which one do you believe is the most important for improving emergency medical care in the US?
I think without a doubt it is Access to Care. ACEP has given this category the most weight. Our nation has too few emergency departments to meet the increasing need of a growing, aging population, and the increased number of people now insured as a result of the Affordable Care Act.
5. On the website it notes that “reducing the incidence of hospital crowding and boarding of admitted patients in the emergency department” is key to improving emergency medical care. Is this simply an issue of lack of funding, not enough doctors to go around, or a multitude of issues?
All of the above! It’s very complex. There is a real primary care and specialist shortage, and lack of available psychiatric beds can clog up the emergency departments with mental health patients. These are just a couple of examples to a very complex problem.
6. What can the average citizen do to help spread awareness about the state of emergency care in the US?
Contact their local lawmaker and refer to the ACEP Report Card. The national ACEP website is ACEP.org. Write a letter to the editor of their local newspaper. Anything to increase exposure about this crucial issue.
