ER nurse sees patients normally treated by primary care

Updated 28m ago
By Marisol Bello USA TODAY

Deborah Franklin runs Express Care, a division of the emergency department. The unit runs from 11 a.m. to 9 p.m., seven days a week, with space for up to six patients at a time. They treat patients who would normally be seen in a primary-care office, with conditions such as sprains, dental pains, rashes or back pain.

"I have people that have had pain for four months because their doctor was not able to see them taking up a bed for somebody that could come in and could have used that," she says.

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Express Care, she says, is "a mirror of the failed primary-care system in our country. It's a sad commentary that I see every single day, patients that have no access to primary care. Sometimes it's because they have no insurance and primary-care docs want to be paid upfront. Or, sometimes, they are their patients and they can't be seen for several weeks and they have a lot of pain, and so their office says just go to the ER.

"They come here because they don't have any access to medical care and they know they won't be turned away. Primary care has failed them."

She'd like to see Medicaid revamped as Washington talks about changing the health care system. "I have patients in every single day that ... could be treated over the counter with, say, a pregnancy test or they could get it free in the health department. But they look me in the eye and say they don't care how much it costs because they are on Medicaid and they don't pay for it," she says.

"I see people that have been here 110 times since January. You get to know them. Some come because they want something to eat or some people just come because they come and there's no reason for them to come. It becomes a real struggle.

"You can't ignore them and not treat them, because this will be the one time the abdominal pain translates into a block or the chest wall pain translates into a heart attack. So every time they come in, you still need to treat them." ... klin_N.htm