As an emergency physician in Richmond Virginia I am asking that you stop DUMAS now.  Patients should never be put in the position to determine if they have a life threatening emergency condition before seeking the advice of a medical professional. We ask that you comply with the "prudent layperson" standard and ensures equal access to health care for all Virginians. The drastic cut in medicaid reimbursements by using "preventable" codes will drastically reduce the income for hospital emergency departments which threatens their ability to adequately staff and thereby treat our citizens in a safe manor.  This will disproportionately effect the most vulnerable in our community, including minorities and the uninsured.  

Sincerely,

Cara Marks, MD