Some attention is finally given to the problem of insured patients crowding the emergency department.

Major health reform proposals focus on covering the uninsured. However, having insurance doesn’t guarantee access to care, and studies show that insured patients are burdening the ED for primary care.

As primary care physicians, we need to do what we can to optimize scheduling. This means open-access, offering same-day appointments. If we cannot capture the same-day, urgent care cases, we will lose this demographic to retail clinics.

An additional problem are barriers that insurers are putting up prior to diagnostic testing.

More and more physicians are taking the path of least resistance and simply sending patients to the ED for CT scans and MRIs, where pre-authroization isn’t needed.

Guarantee physician access first, then worry about the uninsured.