As an Emergency Medicine Physician who has worked for over 10 years in the DC/Virginia area, I have long served a diverse population of patients who all share similar concerns for their health.  It is only AFTER their evaluation and treatment in the emergency department that we are able to stabilize certain conditions and escalate ones that remain critical. Defunding multiple medical diagnoses for the emergency department is a rash, dangerous and uneducated decision. It is imperative that we protect and are able to effectively serve ALL of our patients.

Patients should NEVER be put in a position where they are expected to self-diagnose and determine an emergency condition before being seen by a medical professional.  It is not up to the patient or even the doctor to assume what the final results will be on first interaction.  Once an emergency condition is considered, an emergency department will run all tests deemed appropriate in order to confirm diagnosis. It is only AFTER the evaluation and testing that we can make a definitive diagnosis. Even if the diagnosis eventually ends up being noncritical, final diagnosis is confirmed because other critical diagnoses were FIRST considered and evaluated. It is equally possible that seemingly benign conditions end up being critical. Thoughtful and thorough evaluation comes at a cost of time and money. Many of the conditions listed may be preventable but when they show up in an Emergency Department the time for prevention is past and these are truly emergent conditions.

 I ask that you reconsider this issue and do not pass this legislation, which will reduce reimbursement and financial support for hospitals the provide emergency care to patients.

This issue is also exacerbated by louder calls for greater social justice and racial equality in healthcare. 

 I support the Virginia College of Emergency Physicians and the Medical Society of Virginia and I OPPOSE the shortcuts to reimbursement policy of the ER Utilization program scheduled to be implemented on July 1 2020.  This policy will hurt disadvantaged patients and the hospitals who care for them.

Thank you, 

Teresa M Ross MD