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Op-Ed: To ease hospital crowding, let EMS providers treat patients in place

In a Boston Globe opinion piece, Dr. Eric Dickson says paying ambulance services to care for patients at home instead of transporting them would also cut costs


Dr. Eric Dickson says EMS providers could treat patients on-site under the direction of an emergency physician.

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By Leila Merrill

BOSTON — In an opinion piece published Thursday, a prominent emergency physician describes how and why emergency rooms are overwhelmed and offers an EMS-based way to address the issue.

Dr. Eric Dickson is an emergency physician and president and CEO of UMass Memorial Health in Worcester. He also is the chair of the board of directors for America’s Essential Hospitals.

As he describes it in his Boston Globe op-ed, “The root cause of the problem in emergency departments is not an increase in demand for emergency care. In general, our emergency department visits are at pre-COVID levels. What has changed is our ability to get patients out of hospitals’ inpatient units and into post-acute care beds, which include skilled nursing facilities, rehabilitation centers, and nursing homes. On average, patients are staying an extra day and a half in our trauma center because of workforce shortages in post-acute care settings. When patients can’t be discharged, new admissions back up in emergency departments, creating the crisis we have today.”

Earlier in the pandemic, the Office of Health and Human Services, in partnership with the Massachusetts Health and Hospital Association, monitored inpatient capacity at all the hospitals in the state. That information made it possible for COVID-19 patients to receive care. A similar model could be used to address the capacity issue, Dickson suggests.

He also advocates for EMS providers treating patients in place.

Dickson writes:

“We also need to empower paramedics to care for patients in their homes under the direction of an emergency physician and not transport everyone to the hospital. This would become commonplace if insurance companies were willing to pay emergency medical services the same amount to care for a patient in their home as they do when the patient is transported to the hospital. It would also result in significant cost savings by reducing emergency department visits while taking pressure off already overwhelmed emergency departments across the state.”


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