Why Emergency Room Visits Are So Expensive

Why Emergency Room Visits Are So Expensive

Millions of Americans who visit emergency rooms every year get surprised at the high fees they are required to pay. Compared to a visit to a local clinic, you are likely to pay three times more when you visit an emergency room. A recurring question in many people’s minds is why emergency rooms charge so highly for even the most trivial operations. Well, to understand how the charge is so astronomical, here are a few things to keep in mind:

Cost Shifting

Millions of Americans are uninsured, yet they are still entitled to emergency care benefits whenever they need it. Many of the uninsured are the underprivileged in the society and are unable to pay their bills as a result of being unemployed, underpaid, orphaned, aged, and so on. To cater for the cost of those that cannot afford a health insurance cover, emergency rooms charge those that are already insured an extra amount over and above their bills. For this reason, the bill seems higher than you would expect.

Emergency rooms charge for everything

Every last resource you use at an emergency room, from an aspirin to the syringe, will be charged on your bill. Add that to the services you use, and a trip to the emergency room using the ambulance and the bill comes to a tidy sum. And don’t forget that the emergency room is constantly kept ready to handle emergency cases 24 hours every day. If you use the services of different departments of the same hospital, remember that every department will bill you separately, which is why you are likely to have many quotations even when you visit the same hospital. When these quotations are totaled, they may add up to a large sum.

Some levels of care attract a hefty bill

Many emergency rooms provide several levels of care, with each level attracting a different bill for the services offered at that level. For instance, you will pay less for having your earache addressed as you would for having a stroke. However, since the staff is always ready to serve you even when you are coming in for a minor issue, you will still pay a considerably higher amount so as to offset the cost of more complicated problems, especially if more people are coming in for less expensive treatments.

Different parties are involved in the billing process

One of the reasons you have a significantly high bill for emergency room services is that your provider, the hospital, and your insurance are interested parties in the billing process. The emergency room must come up with a figure that is higher than would have been the case since the insurance will bargain for a much less bill. Here’s an illustration: let’s assume your hospital charges you $6500, your health insurer might be willing to give only $700! Insurance companies are experts at bargaining, so don’t be shocked if you end up paying $1000 for the same bill. And that’s not all; your insurance will still want a slice of the $1000 depending on what is stipulated in your agreement with them as a repayment.

The costs of running an emergency room are high

A lot of the costs that an emergency room incurs are administrative, and these may be astronomical. There are many billing clerks and other hospital personnel in the emergency rooms that are always on the standby for emergency cases. The doctors are highly trained and experienced to handle emergency cases. Add this to the high-tech equipment and modern facilities in many emergency rooms, and the cost of simply running the facility becomes apparently high. This cost is eventually reflected in your health bill, whether you have visited the room with a life-threatening condition or you needed merely a few stitches.

Some of the drugs are very expensive

Some of the cases treated in emergency rooms, such as stroke, require very expensive drugs. In many cases, those that visit the ER with these cases are unable to pay for them. To cater for these bills, emergency rooms have to transfer a percentage of the costs to the bills of those that can afford to pay, hence making a visit to the emergency room becomes rather expensive.

The bill is covered by your insurance cover.

The reason for the inflated prices of emergency room services is that the insurance provider will foot the bill. For this reason, even simple drugs such as aspirin may be charged at well over $20 for one pill while an entire bottle of them costs less than a quarter of that at a drugstore.  

What should you do?

The fact that the emergency room services are costlier than those provided in other medical facilities cannot be disputed, but you need not be overly worried. Some emergency rooms in America are more willing to take care of your health at a cost that is friendly. Bellaire ER has for years provided Houston residents high-quality emergency services at very friendly rates.  A good emergency room should be able to offer prompt health care when required just like Bellaire ER, have no waiting time. In many emergency situations, immediate attendance may make the difference between life and death.

Who runs the emergency room

Who runs the emergency room

The ER is one of busiest places in the hospital. Each year, ERs such as Bellaire ER receive over 100 million people. They act as a safety net for millions of people who are unable to access proper health care.

Knowing how the ER is run could help to relieve some of the anxiety that comes with a visit to the ER. Besides that, it may help to reduce the amount of time you need to spend at the ER since you know who provides what services.

The Wait

The first person who contacts you at the ER is not the medical personnel. You will first speak to an administrative registration clerk. He or she will take your name and other personal details, including your date of birth. Additionally, the clerk will take information about your insurance provider.

After you are booked into the ER, you will then see the triage nurse. The term triage originated during the war. The nurse organizes you according to how much care you need and how soon you require receiving care.

In the ER, you should remember that care is not on a first come first serve basis. For instance, if you get to the ER and you are unconscious, you have symptoms indicative of a heart attack, or in an ambulance, you will receive care first. Someone who has a twisted ankle may have to wait a bit long. Sometimes, the triage nurse may determine that you do not need any care.

The Treatment

Once you move from the triage level, you will be received by an emergency department nurse in the treatment area. This nurse has a degree in nursing and training on how to handle emergency cases.

The emergency nurse handles everything. He or she can clean wounds, suction an airway, aid in a neurological evaluation, arrange for transport to another hospital, among many other functions. In some cases, you may also find a charge nurse.

He or she is in charge of all the nurses in the ER. The charge nurse oversees the dynamics of the ER and manages complex cases. The charge nurse may also assist the primary ER nurse to provide preliminary intervention for anything that you have.

In the treatment area, you will be received by the doctor after the nurse is done with you. Over 85% of all patients to the ER will get to see the doctor. The ER doctor will usually have completed medical school and their residency. Previously, most ER doctors had a background in family medicine, internal medicine, or surgery.

However, the ER is now mostly staffed by doctors who have full-time training in emergency medicine. Additionally, the ER doctor consults with other specialists as he or she treats patients in the ER such as cardiologists, neurologists, and many others.

In the ER, you will only get to see the attending doctor. However, if you go to an ER with a university affiliation, you may encounter medical students and resident doctors. Although the medical students can assist with care, they cannot direct your treatment.

Other People in the ER

In the ER, besides doctors and nurses, you may find physician assistants (PAs). PAs are qualified to practice medicine but under the direction of a doctor. There are also Nurse Practitioners (NPs), who are nurses that have masters or advanced training to handle patients in the ER. Though NPs and PAs provide care in the ER, they do so under the direction of a doctor.

In the modern ER, you may also find technicians who operate the equipment used there. These types of technical staff perform most of the medical testing. However, they are not in a position to respond to issues related to the test results.

If you are injured and required to be transported to the ER, you may encounter Emergency Medical Technicians (EMTs) on your way to the hospital.  These pros monitor your vital signs, provide care such as CPR, administer medication, and perform complex procedures.

Severe Cases

If you have severe trauma, a group of ER personnel will attend to you. The trauma team includes a surgeon, the attending doctor, a resident doctor, a specially trained nurse, and possibly a pharmacist to give you medical care.

In the ER room, you may also find a social worker or a chaplain. These people are intended to provide family members with the support they need. They can also relay questions to the medical officials that the family may have.

In some cases, you may find sexual assault nurse examiners or forensic nurses. These are nurses trained to collect evidence to treat patients that are victims of violence. Additionally, you will find escorts within the ER.

The transport team will assist you to move from the ER to other sections of the hospital. Outside the hospital, you will meet the transport team; they work to provide care to the critically injured. To avoid confusion, the medical staff at a hospital communicates via medical records.

Information keeps getting added to the medical record from the moment you make the first contact with the ER. If you have always wondered how the ER room runs, that is how the entire process works.

Who Invented the Emergency Room

Who Invented the Emergency Room

Television shows like ER have helped to romanticize the field of emergency medicine to the US public. However, the emergency room is at the center of a vicious battle. There are those that view the emergency field of medicine as a sinkhole that keeps sucking in money.  

How it began

The emergency room began after the Second World War. One of the reasons it rose was because of the baby boom and urban sprawl; the medical sector was forced to adapt. Physicians venturing away from the office to make home visits became increasingly hard.

After a while, house calls became impractical. Additionally, the federal government began to offer more support for hospital-based care rather than care offered at the home or the office. Another factor was that specialists began to increase. More specialists were spawned out of WW II.

Hospitals began to be viewed as life-sustaining centers. Besides that, there was the development of increasingly sophisticated diagnostic equipment such as the CT scan and cardiac monitoring. These devices allowed for emergency interventions to take place.

Besides that, experienced gained from the war on pre-hospital care made it feasible to have an emergency room. The Korean War brought on the realization that emergency care was seriously underfunded. It was usually a small room with a single overworked nurse.

In 1961, a group of four physicians from Alexandria, Virginia, left their practices and began to offer full-time service in the emergency department. Soon, other physicians in Flint and Pontiac, Michigan followed suit.

Later in that decade, the American College of Emergency Physicians was established by eight physicians in 1968. It helped to establish the process of educating future physicians of the emergency department.

The University of Cincinnati was the first to establish a residency program for the field in 1970. By 1975, the number of approved residencies had grown to 23. There were two academic departments handling emergency department with 100 residents.

On that year, emergency medicine became a permanent section after approval by the American Medical Association House of Delegates. The American Board of Emergency Medicine was approved in 1979 by the American Board of Medical Specialties. With that, it became the 23rd specialty recognized in US medicine. Certification for the specialty began the following year.

Shortly after, the requirements for joining an emergency residency training program were approved. Since 1982, the specialty has branched out into three subspecialties. These are medical toxicology, sports medicine, and emergency medicine.

Emergency medicine has experienced some phenomenal growth since the 80s. One of the things that spurred emergency medicine into the limelight was the attempted assassination of President Reagan in 1981.

Research published in 1985 helped to shed a spotlight on the need for in-hospital trauma care. The COBRA law passed in 1986 made it mandatory for hospitals to provide emergency care and stabilization without regard to a patient’s payer capability.

How Far the Emergency Room Has Come

In the early days, residency programs for emergency room doctors were not quite effective. In most cases, the trainees would learn through trial and error. When they rotated to other services, they were often viewed as oddities pursuing an unrecognized field of medicine.

The first emergency room doctors had to fight in the emergency room as well as with politicians to receive recognition. Although it took quite long, it helped to open the door for the approval of other fields of medicines. The struggle led to the creation of an official system for the approval of new fields of medicine.

Unlike the emergency room doctors of today, those of that era did not know their future. They had no certification board and had no guarantee that they would have a job in the next few years. They were mavericks who persevered amidst all the stress and anguish that it must have caused them.

Despite the lack of specializing equipment and funding, they managed to learn from each other. They helped each other by staying in constant communication with their peers.

Since then, visits to the emergency room have continued to grow. There was a small drop in visits in 1995, but the figure continued to grow. It is estimated that the emergency room receives around 100 million cases each year.

A significant number of these patients are the 41 million uninsured Americans who cannot afford regular care.  For them, it is the only way they can access modern medicine. The emergency room is increasingly seen as the only option for the uninsured and underinsured in the country.

The Current Numbers

In the US, there are about 5,000 emergency departments such as Bellaire ER. Besides that, an estimated 25,000 physicians are working in these departments. There are about 2700 physicians undergoing training to become certified emergency room doctors in the country.

The emergency medicine department is one of the most competitive for medical student applicants for over a decade. ACEP, which had just eight doctors in 1968 now has about 20,000 members. Additionally, there are over 4,000 members in the organization of academic emergency medicine.

Within the country’s medical schools, 50 departments teach emergency medicine. Additionally, there are over 20 sections and divisions that handle this field of medicine.