Although it’s often presumed that emergency room visits are for people without health care coverage, a new poll of emergency physicians shows that’s not the case.

According to a new survey from the American College of Emergency Physicians, 97 percent of ER physicians reported treating patients on a daily basis who were referred to them by primary care doctors.

That same percentage said they treated patients “daily” who have Medicaid, the federal-state health plan for the low-income, but who can't find a doctor who will accept their insurance. If the new health care reform legislation provides insurance coverage that reimburses doctors at Medicaid rates, this could exacerbate a lack of access to medical care, the survey showed.

“Many of my patients do what they are supposed to do — they call their primary care doctor when they have problems,” says Darria Long Gillespie, a resident physician at Yale Department of Emergency Medicine. But primary care doctors often worry they don’t have the time or resources to treat them and instead send them to the ER, she says.

“Many of [the ER patients] have Medicaid or a primary care doctor but it doesn’t mean they get the care they need,” Long Gillespie says.

More than 80 percent of ER doctors surveyed by the ACEP said emergency room visits are increasing in their departments, with half reporting significant rises. Some 90 percent are expecting increases in the next year as health care reforms are implemented.

Visits to ERs reached an all-time high of nearly 124 million in 2008, according to the Centers for Disease Control and Prevention, and are expected to rise nationwide.

Although “in spirit” the health care bill has good intentions, it doesn’t address the ER problem, Long Gillespie explains. “You can’t just say these people need to have coverage and have a primary care doctor. In reality, you have to look at how it’s actually going to be executed. Who is going to take care of these people?”

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ER visits will increase with health care reform, doctors say

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