[Sparkyte]

If you add a level of mandatory screening you can filter out ER to Urgent Care. The problem is still the connotation that ER is for everyone. Just put up posters in the ER lobby that make people uncomfortable things that say ER is for like car accidents. No one wants a reminder, but no one wants to be that asshole cutting in front of the guy who got a broken clavicle from a seatbelt or other various injuries.

[hundreddaysoff]

This has been suggested many, many times in my career. The problem in the US is that such posters would violate[0] a federal law called EMTALA, which prohibits an ER from turning away any patient for any reason until I or another provider has performed a Medical Screening Exam (MSE) to assess for A Real Emergency (TM).

EMTALA and confusion around it is another common reason why patients often stay in the waiting room for many hours when really it would be in their best interest to go home and go to a clinic during the daytime. It is the main reason I try to ~break all the soft rules at night and just go out into the waiting room and MSE anything that moves so I can send it home.

EMTALA was passed in the 1980s under Reagan I believe. Good luck repealing it or revising it to make sense in our current political environment!

[0] Or appear to violate the law in the optics of some administrator, insurer, healthcare bureaucracy maintenance organization visitor, etc. In this way, in large bureaucracies, magical thinking reigns, optics becomes objectivity, and 2 + 2 = 5 .

[Sparkyte]

It isn't about turning a person away, it is about enqueuing them into another emergency type care, urgent care is still a high priority but it is urgent and not deathly required.

This would allow prioritization of people needing immediate care.

[hundreddaysoff]

I happen to agree with you. I was writing not my opinion, but my experiences with the actual EMTALA law, or more accurately and importantly my healthcare administrators' perception of said law. I cannot change either of these things.

[PKop]

>but no one wants to be that asshole cutting in front of the guy who got a broken clavicle

Hang around an ER and I think you'll see this isn't remotely true.

>mandatory screening you can filter out

This would be great but is unfortunately illegal.

[Sparkyte]

Illegal if you don't have an urgent care facility attached.