Erik Gulbrandsen, D.O.

I think that public aid patients should be treated like an HMO. They need to go through the PCP and get their permission to go to the ER. Much of what we do in the ER cN be taken care of in clinic. Patients don't understand this, but we, as physicians do. Patients are notoriously bad at triage.

How do you punish a patient for going to the ER without consulting the PCP? That is a really difficult question. If you don't pay for the visit, the hospital gets hurt because they are required to evaluate all patients due to EMTALA. so, there has to be a change to the law. I'm not an attorney, so I don't know how this would all work. Maybe the hospital can refuse to see patients that have been denied access to the ER by their PCP.

Dealing with this issue can go a long way in reducing our healthcare costs. I doubt this would happen because our current vogue thing to do in politics is more strict democracy (we aren't living in a democracy, we are a constituitonal republic...big difference). Our current structure is to please the masses, which could be the exact opposite of what is best for the masses.