Implications of current procompetitive approaches on EDs |
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| Affiliation: | 1. Uniformed Services University, Naval Medical Center San Diego, San Diego, CA;2. Stony Brook University, Stony Brook, NY;3. Institute for Healthcare Optimization, Harvard T.H. Chan School of Public Health, Boston, MA;1. Department of Medicine, University of Toronto, Toronto, Canada;2. Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN;3. Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Canada;1. US Acute Care Solutions, Canton, OH;2. Department of Emergency Medicine, Summa Health System, Akron, OH;3. Heller School for Social Policy and Management, Brandeis University, Waltham, MA;4. Pritzker School of Law, Northwestern University, Chicago, IL;5. Adventist Shady Grove Medical Center, Rockville, MD;6. Department of Health Policy and Management, the Milken Institute School of Public Health, George Washington University, Washington, DC;7. Department of Emergency Medicine, Allegheny Health Network, Erie, PA;8. Department of Emergency Medicine, Sinai Hospital, Baltimore, MD;9. Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA |
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| Abstract: | Health reform is now predicted to occur in the marketplace without much further governmental intervention. The major vehicles driving this fortuitous trend are the managed care plans, capitated payment, and the development of complex and fiscally awesome health networks organized by hospitals, physicians, and health insurance companies. In the context of this procompetitive environment, potential decreases are projected in current emergency department (ED) volumes, demand for emergency medicine (EM) physicians, and anticipated workload and remuneration of doctors working in EDs. Eventually, mandated universal insurance for 260 million Americans will create a slight increase in total ED visits; additional cost constraints will force the closure of a number of hospital EDs; and EM specialists will experience less ideal working conditions, requiring them to work more hours to maintain their current incomes. |
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