The role of emergency medicine has been erroneously misrepresented during the health-care reform debate. It’s time to debunk the myth that decreasing emergency department visits will create a substantial savings as a down payment for the proposed health-care plan.

The 120 million annual visits made to emergency departments in this country account for less than 3 percent of all health-care spending. This percentage, when applied to Moore Regional Hospital, provides for the treatment of 67,000 patients annually.

When other facilities are closed weekends, holidays and nights, the emergency department remains fully staffed and ready. It remains accessible with state-of-the–art diagnostic equipment and emergency medicine specialists and draws on many hospital resources quickly while providing coordinated efficient patient care.

The fixed cost (overhead cost) of being open 24/7 is high, but the variable cost (incremental cost) for seeing additional patients in the emergency department is the same as anywhere else care is provided.

Alternative treatment centers require duplication of personnel, overhead and equipment. Savings incurred from diverting patients in a national health-care system would be minimal due to the high, fixed cost required to maintain Emergency Departments in their operational state of readiness. Since enacting its universal health care legislation, Massachusetts has experienced an increase in emergency department patients.

With a growing and aging population, our role in providing care to the sick and injured any time day or night, and our front line role in responding to manmade and natural disasters, will be in even greater demand in the future. An emergency department cannot be turned off and on like a faucet with the expectation of realizing significant health-care savings by diverting a few non-emergency patients.

Ronald J. Milewski, MD

Sandhills Emergency Physicians

Southern Pines