Coronavirus spotlights overuse of hospital emergency rooms

Publication: Washington Examiner

Date Published: May 15, 2020

Author(s): David Hogberg

Patient visits to emergency rooms have dropped precipitously since the onset of the coronavirus pandemic, in some places declining as much as 50%. The results may indicate a reduction in ER overuse.

“The services provided to some patients in the ER are not necessarily unnecessary. It’s that these patients are in the wrong place,” said Shannon Brownlee, a senior vice president at the Lown Institute and author of the book Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer. “It is unnecessary to provide them with services in the emergency room, which is one of the most expensive places to get treated.”

“On the one hand, I’m sure there are people out there who have been harmed by not going to the ER,” said Brownlee. “At the same time, some people may have been helped by not having stuff done, like unnecessary CT scans.”

What exactly causes ER overuse is a matter of considerable debate.

“For people who have no insurance or are poorly insured, the ER has been the location for them to receive for a long time,” said Brownlee. “And even with the Affordable Care Act, which has increased insurance for more people, they had gotten into the habit of going to the ER because they didn’t have a primary care doctor.” Brownlee also blamed the way our healthcare system pays doctors, which she believes is responsible for a shortage of primary-care physicians.

To eliminate medication overload, serious cultural, educational, and policy changes are needed. This action plan offers recommendations for policymakers, health care institutions, clinicians, and patients across five key categories to reduce harm from multiple medication use. Suggested Citation: Eliminating medication overload: A national action plan. Working Group on Medication Overload. Brookline, MA: The Lown Institute, 2020. DOI: https://doi.org/10.46241/LI.YLBW4885

Pharmaceutical marketing is a significant factor in the growing public health crisis of medication overload, which puts millions of older adults at risk of preventable harm and premature death. This issue brief provides recommendations to reduce pharmaceutical industry influence by limiting pharma sales rep visits to clinicians and direct-to-consumer advertising.

This issue brief provides recommendations for clinical practice guidelines and electronic health records that would give clinicians the information they need to appropriately prescribe and deprescribe.