Thanks in a large part to television and movies, the popular impression of hospital emergency rooms (ER) is that it is a place where the life and death treatment of patients suffering from traumatic injuries are attended to. The reality, however, is that ERs are a place where people go to receive care for a variety of health issues, which include life threatening trauma, but also entail treatment of such problems as sore throats, stomach aces, and minor broken bones.

This is because outside of normal business hours, people who need medical attention are directed to the ER. Also, people who cannot find care anywhere else, for reasons that include not having insurance, must go to the ER. This, in turn, can place an undue burden on ERs, resulting in overcrowding and longer wait times.

Unfortunately, the problem could become worse under the new health care plan recently passed by the government. This may contradict the perception that with millions of more Americans getting health insurance through the bill, they will not have to rely on the ER for medical care. However, it turns out that people with insurance are just as likely as the uninsured to use ERs.

When you include the fact that the number of people on Medicaid, who are the biggest users of ERs, is predicted to increase by as many as 16 million people, it is easy to see that the burden on ERs might only get worse. Also, many family doctors set limits for the number of Medicaid patients that they will see due to low reimbursements from the government.

The situation is compounded by the potential shortage of primary care physicians stemming from doctors choosing more lucrative and prestigious specialties. Under these circumstances, a growing number of patients could be forced to turn to already over-burdened ERs to receive their basic health care, thereby aggravating an already difficult situation.

The crowding of ERs has been an ongoing problem in this country, with a recent report indicating that some patients in need of immediate care are left waiting for as long as 30 minutes. Though steps are being taken to increase the number of primary care physicians, many experts argue that the problem with overcrowding in ERs is a more complex situation, involving more than simply increasing the number of general practitioners.

Part of the problem is the decline in the number of facilities, many of which closed during the '90s, in conjunction with the dramatic increase in ER visits. Also, there are economic issues involved. Patients in ERs take beds away from patients who are scheduled for elective surgeries, which bring in more money.

Hospitals are experimenting with novel approaches to decrease time spent in ERs and thus ease crowding. These measures include increasing administrative efficiency as well as offering effective alternatives to ER visits, but more work may be needed to investigate the situation.