Why your patients seek primary care from the emergency department

A recent study described 60 persons who returned to an emergency department (ED) within 9 days after being discharged from it. (The study, "Return Visits to the Emergency Department: the Patient Perspective," was published online on September 2, 2014, in Annals of Emergency Medicine.)

In most cases, that subsequent ED visit was a quest for follow-up care for the condition that had originally brought the person to the ED. Most of these patients did report having a primary-care provider they could have consulted instead.

According to the lead author of that study, Kristin Rising, MD, MS, director of acute care transitions in the Department of Emergency Medicine at Thomas Jefferson University in Philadelphia, the most frequent explanation participants gave for choosing the ED over primary care was that outpatient clinics lack the necessary resources to complete the workup and treatment and to sufficiently address patient symptoms.

The Clinical Advisor asked Dr. Rising how primary-care nurse practitioners and physician assistants could keep their patients from making return trips to the ED in search of care they should be receiving from these clinicians. Here is her response:

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