Reflecting on the E.D. Advantage

It is upsetting that the emergency department has become a source of primary care for so many Americans. I agree with Woo that the quintessential component and reward of primary care is longitudinal relationships. For example, she describes the joy of “[seeing] firsthand how social factors affect patients who have chronic diseases.” She also describes her fascination at witnessing how patients’ symptoms are a manifestation of various pathological, social, and personal factors. The use of emergency departments as primary care undermines this long-term and comprehensive patient-doctor relationship. And quite frankly, as a member of the future physician workforce, I feel a bit “cheated” of a fully meaningful relationship with my future patients as the American healthcare system depends more heavily on emergency rooms.

However, I tried out reflecting on this matter from a slightly different angle. I tried identifying myself as a member of the future generation of healthcare workers, or of social justice advocates, versus of physicians. From this angle, I was able to see more optimism in current trends of American healthcare usage. For example, the recent rise in emergency department use opens a critical portal for social workers to reach those who need such help. Were I a social worker, this trend would indicate the inadequacy of the current system to fully and timely meet individuals’ or communities’ health-related needs. However, because disease is often a physiological manifestation of less-than-ideal social, economic, and mental conditions, this national trend would identify for me a pool of individuals who could benefit from social services. I realize, though, that finding people in need of a social worker’s expertise is hardly a high-ranking enigma for the social work task force. There are probably plenty of people in America who would benefit from social services, and, as is the case for the health care system, need is not the factor in short supply.