In nearly every emergency room across the country, there are patients waiting to be seen that do not require urgent care. This problem leads to overuse of the emergency department, contributing to ever-increasing healthcare costs.

A 2011 survey conducted by the Centers for Disease Control and Prevention (CDC) reports nearly 50 percent of the patient respondents were in the ED because they did not know where else to go. These patients visit the ER because they do not have a family physician, do not have adequate healthcare coverage or do not know about alternative options.

A 2010 Health Affairs study determined approximately 14 to 27 percent of the visits to the ER within the United States are not considered emergencies. This leads to around $4.4 billion in healthcare costs. The kinds of visits that could be treated elsewhere include minor lacerations, sprains, strains and infections.

According to James G. Adams, M.D., discussions related to the misuse and overuse of ERs have continued for 40 years. ER misuse and overuse have remained long-standing policy priorities in the nation, receiving specific attention from presidents Bill Clinton, Lyndon Johnson, George Bush and Barack Obama, yet the number of visits to the ER continues to rise. The increase is substantial: from 44 million patients in 1968 to about 134 million visits annually today.

Here is a look at some of the problems and possible solutions surrounding this issue.

Problems

Doctors' schedules

For the most part, physicians work 9 a.m. to 5 p.m., or hours equivalent to that. Patients can become injured or ill anytime of the day or night. When their physician is unavailable, the ER is where they turn. Hospitals are obligated by law to give care to any person who comes in seeking treatment.

It is understandable that physicians want to work reasonable hours, with weekends, evenings and holidays free to be with their friends and family. However, these gaps need to be filled in such a way as to avoid unnecessary costs.

Middle class

The insured middle class, who are unable to reach their physicians, are the largest contributor to the rise in ER visits for nonemergency medical issues.

Emergency room overuse is a costly problem resulting in long wait times and overcrowding, which leads to additional stress for health professionals. This additional stress could inhibit the ability for these professionals to treat people who are suffering true emergencies.

Money wasted

In 2010, the New England Healthcare Institute (NEHI) issued a research brief reporting on the overuse of EDs. The brief states that this overuse is responsible for wasting as much as $38 billion in the United States annually. Estimations indicate that almost 60 percent of ER visits are avoidable (NEHI Reducing ED Overuse).

Solutions

Urgent care clinics

Many towns and cities have begun implementing urgent care clinics. These clinics are often part of a hospital and are ideal for patients suffering minor illnesses/injuries. Here, they can seek care without an appointment or long wait time.

On-call physicians, PAs

Group practices can have their physicians and PAs take turns being on-call after hours and on weekends or holidays. When a solo practice office is closed, physicians should give their patients a number to call in their recorded message should they need nonemergency medical assistance.

Educate patients

Patients with chronic conditions sometimes lack the information necessary to understand their conditions, making it difficult to cope with changes. Educating these patients about their conditions can assist in alleviating concerns when symptoms do arise.

Create a care plan

Physicians need to create a plan for their patients suffering with a chronic medical problem. Creating this care plan may reduce their need to seek unnecessary emergency care.