From Dr. Richard Besserman to me via email:

Yes care is limited here. Only parts of the system are broken but can be fixed.

People demand immediate care and thus abuse the system. They have no one to take the children to the clinic so they come in during off hours or on weekends.

If you have the misfortune to visit an emergency room you will likely have a long wait unless your condition is very acute (life threatening) and even then you may still have to wait.

The problem is compounded by the fact that our emergency rooms are flooded with a variety of patients who do not need urgent care.

Many visits are referred after hours and are seeking general medical attention, others have no formal medical link to a practitioner, others may be uninsured, and others may be uninsured and hiding because of their illegal status.

I went to the ER a few months ago (thought I might have appendicitis) and had to wait 6 hours to see a physician. People before me had minor cuts, sprains, bruises and a wide range of problems that could have been managed elsewhere.

Malpractice issues demand that everyone be seen, diagnosed and treated.

I do not have an answer for this problem and the proposed healthcare bill does not address the issues.

I like the Chinese approach – pay the physician to keep people well and out of an urgent care setting unless they truly need to be there.

We can learn a lot and embrace much from other organizations that address problems in real time in the work environment – military, etc. Remember “sick call.”

The uninsured get care that rivals the insured but they clog up the ER system and everyone suffers.

Our priorities have become distorted. Lawyers have forced physicians to over-order tests.

Docs don’t have time to do the best for their patients – listen to the patient. Most diagnoses can be made on history alone.

ERs should not treat non-emergent (insured or uninsured) – these people should be seen in another venue, the insured in a physician’s office, and the uninsured in a clinic run by local government health departments. That was how it was and should be again. Social workers can tend to socioeconomic and convenience issues – that is not the job of an ER. They can teach their clients how to “game” the system.

We have the best system and are unnecessarily burdening it by failing to curtail unnecessary visits to the ER.

Again find the problems and address them. Things will improve.We know what does not work. It is not rocket science. Implement national tort reform – eliminate waste and unnecessary expense. You will be off to a good start.