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

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According to a new survey from the American College of EmergencyPhysicians, 97 percent of ER physicians reported treating patientson a daily basis who were referred to them by primary caredoctors.

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

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“Many of my patients do what they are supposed to do — they calltheir primary care doctor when they have problems,” says DarriaLong Gillespie, a resident physician at Yale Department ofEmergency Medicine. But primary care doctors often worry they don’thave the time or resources to treat them and instead send them tothe ER, she says.

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

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More than 80 percent of ER doctors surveyed by the ACEP saidemergency room visits are increasing in their departments, withhalf reporting significant rises. Some 90 percent are expectingincreases in the next year as health care reforms areimplemented.

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Visits to ERs reached an all-time high of nearly 124 million in2008, according to the Centers for Disease Control and Prevention,and are expected to rise nationwide.

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

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