ACEP National Report Card Shows Emergency Medical Care Still Lagging, Getting Worse

Wyoming is a beautiful state, with lots to offer. Many people – some of them Arizonans – travel there to vacation. Best to be warned, however: whatever you do, avoid needing emergency medical care in Wyoming. The American College of Emergency Physicians recently released its national report card on emergency care and, while nearly every state scored poorly, Wyoming was easily the worst, receiving an F grade in every category but one…in which it received a D-. The ACEP issues letter grades in a number of emergency care categories, and this year’s report card is an embarrassment.ACEP National Report Card

But the real story is the state of emergency medical care nationally.  Our nation’s overall grade dipped from a C- in 2009, to a D+ this year. “Access to Emergency Care” across the U.S. remained at a dismal grade of D-.  Worse yet, despite the continuing threat of terrorism and a series of devastating natural disasters since 2009, the ACEP rated “Disaster Preparedness” lower than last time, as it fell to an alarming C-. This is likely due to a decrease in funding and wide variations across states in hospital capacity and staff preparedness. In short, almost no one did well; it looked in some respects to be a race to the bottom.

Arizona kept an overall grade of D+, and this actually moved our state UP in its national rank, from 45th in 2009, to 31st this year! This is the state of our nation’s emergency medicine apparatus: Arizona rates a D+ overall, and is still judged to be superior to 19 other states! Sadly, our state also kept a failing grade and its national rank of 48th in “Access to Emergency Care,” joining 20 other states with an F grade in the category. By now you must be asking: “Is good emergency medical care available anywhere?”  Sure.  Here and there. In this city or that neighborhood.  But viewed from fifty thousand feet, as they say, no state was found to be without serious flaws. For example, the District of Columbia topped the list with an overall grade of B-, but while it led the nation in multiple categories, D.C. also received an F and ranked dead-last in “Medical Liability.” In short, even the winners were losers.

When the Emergency Physicians themselves rate emergency medicine this low, it should be national cause for concern. These rankings are not some new indictment of changed healthcare insurance, but have been dismal for years now.  And we at MKR have seen many, many instances of substandard ER care, so we know these holes in the system exist. The physicians lay some of the blame, however, on mandates like the Emergency Medical Treatment and Labor Act (EMTALA), which requires emergency departments to screen and stabilize anyone who presents an emergency medical condition, but doesn’t provide funding to assist with what are often uninsured patients presenting to emergency rooms because they don’t have anywhere else to go.

It will be interesting to see the effect of broader health insurance on the ability of emergency rooms to provide good medicine when the next study is completed.

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