State Gets Failing Grade in Emergency Care

A national Report Card on the state of Emergency Medicine out today gives Texas failing grades for doing a poor job of making emergency care available to all its citizens. Jim Bell reports on what some doctors think needs to be done about it.

The American College of Emergency Physicians is giving Texas grades ranging from "A" to "F" in several categories.  That "A" is for the healthy medical liability environment created by tort reforms that put limits on punitive damages. Texas gets a "B" in patient safety, but it gets "D's" in public health, injury prevention, and disaster preparedness, and a failing "F" for access to emergency care. Dr. Nick Jouriles of the College of Emergency Physicians says Texas has always been slow to embrace the concept of emergency medicine.

"Ohio, California, were some of the areas that readily accepted emergency medicine, and Texas was somewhat slow to do that, and powerful institutions, like Baylor and the UT system, really kept emergency physicians out for a long period of time.  That is now starting to change." 

Jouriles says it's also true that Texas has more uninsured children and adults than any other state. Add the economic downturn that's forcing budget cuts everywhere, low childhood and adult immunization rates, ER's bursting at the seams, and you have the Texas situation in a nutshell.

"You have a specialty that has never been especially well funded, combined with the financial crisis that we're in currently where there's not much money for anything these days, and the fact that emergency medicine has been playing catch-up, and your population is increasing, that's a particular challenge for the state of Texas." 

Dr. Richard Bradley of the University of Texas Health Science Center says it's tragic that the state with some of the most famous medical centers and hospitals in the world has so many people who don't have access to primary care doctors.

"My E.D's that I work in my emergency department, they're overcrowded on a daily basis.  The reason they're overcrowded, by and large, is that a lot of our population can't get into primary care." 

The solutions, Bradley says, are in getting health insurance to more people, more funding for emergency medicine generally, and more doctors in specialties where they're needed.

"The state of Texas needs another 665 or so additional primary care providers.  We also rank among the worst in the country in terms of both orthopedic and hand surgeons, emergency physicians, and also registered nurses." 

Visit the National Report Card on the State of Emergency Medicine, with state by state breakdowns.

Jim Bell, KUHF, Houston Public Radio News.