Dr. Marcus Lee

I remember taking my wife to the ER for a severe headache. The ER Doc stuck his head in the door and said “Hi” and “we will take care of you.” Some lab work, a Cat Scan, and a shot later, we were on our way home. The headache was no better, but after a good night’s sleep it was gone.

Some weeks later, I got the mail and noted a bill from the ER. I tore it open and was floored by the bill. We paid the ER Doc $700 (for those 7 words!), the ER got $3000, radiologist got $100, and the Radiology Dept got $1000. This was 10 years ago.

Now, it is not unusual for me to hear about a $7,000 bill from the ER. An admission to the hospital? $30,000 easy. I went to a meeting and we were discussing the relative costs of outpatient versus inpatient care. The lecturer informed us that we could see a patient with a chronic illness EVERY DAY in our office and it still not equal the cost of one hospital admission. Let me repeat. I could see someone 240 times a year and the money would not equal to ONE hospital admission!

So how do you know when to go to the ER? I can tell you some general guidelines. If you have chest pain that is not clearly reflux, then go to the ER. If you have numbness, weakness, double vision, or difficulty speaking, then go to the ER. If you have unexplained shortness of breath, then go to the ER. Otherwise, go if you think you need to. Even better, go to the ER if your doctor tells you to go.

I suppose the most cost-effective way to avoid the ER is to get it taken care of in an outpatient setting, but that is often impossible. I suspect it wouldn’t be as hard if a few of those hospital dollars found their way into the outpatient clinics. Unfortunately, that really would take an act of Congress.