For many years I worked in a high-volume, urban ED. I treated people--who became patients--for everything you could imagine: a fork stuck in an eyeball causing an ocular rupture, a nose bleed that put a person into volume shock because of how much blood was lost, abdominal pain that turned out to be an ectopic pregnancy, an achy leg which turned out to be a fractured femur...and on and on and on. Sure, I also saw people seek 'emergency care' for heartburn, lice, sexually transmitted diseases, skin lesions, mild sunburns and on and on and on..... But how on earth can we expect the 'lay public' to know when to seek emergency treatment and when not to?  Honestly--think about this..many people do not have primary care doctors so they come to the ED...many people do not want to wait weeks for an appointment to see a doctor so they come to the ED...many people don't know if they are truly sick or not truly sick...so they come to us. Until there is more access to care in communities where people live, then we will always have people coming to the ED--whether they should or not...and we need to cover the costs. …see more