January 2006
This week Arizona earned an overall grade of D+ for public policy and emergency care resources, finishing 42nd compared to other states. This first-ever National Emergency Care Report Card produced by the American College of Emergency Physicians confirms what the healthcare community has been saying for several years, but it is the first time Arizona has been compared to other states.
The Report Card looked at each state using 50 objective and quantifiable criteria to measure emergency care public policy, availability of emergency services, and the medical liability environment. It is a tool for understanding problems so that effective solutions may be targeted and it establishes a baseline for measuring future progress.
It is important that the public know Arizona hospitals, emergency physicians, and nurses continue to provide high-quality care for their patients. This Report Card focuses on whether state laws, policies, and available resources are appropriately supporting emergency care systems. It is not an assessment of the providers of emergency care.
We were encouraged that Arizona received better individual grades in Quality & Patient Safety as well as Public Health & Injury Prevention. But despite recent efforts to build more hospital capacity in Arizona, we are concerned that many emergency departments continue to operate "at" or "over" capacity with a chronic shortage of on-call specialists and nurses. We fear healthcare services are simply not keeping pace with the huge increases in the Arizona population and the coming onslaught of the "baby boomer" generation.
For example, Arizona still has one of the worst shortages of physicians in the country. More than half of the state's emergency departments do not have on-call neurosurgeons; hand surgeons; vascular surgeons; plastic surgeons; ear, nose and throat specialists; and gastroenterologists. The specialists needed to care for serious injuries and life-threatening emergency medical conditions are often times not available at some hospitals. We need a coordinated system in Arizona to deal with this situation. Also, other states like California, Texas, and Georgia have reversed the exodus of doctors by aggressively addressing issues- like unmanageable professional risk-that drive physicians away.
Governor Napolitano and lawmakers are proposing that the Legislature appropriate funds to train more physicians who provide these vital specialty services, and we applaud their efforts. And while nurses are also in short supply, the Arizona State Legislature helped address this during the 2005 legislative session by providing $20 million-$4 million annually for five years- to expand the capacity of the state's publicly funded nursing education programs.
This Report Card is a serious wake-up call - It's time to fix our broken healthcare system.
Emergency care is a window into our entire healthcare system. The medical community is working as hard as they can to provide medical services to everyone within the constraints of our fractured healthcare system.
We must improve the medical liability legal process to make it realistic, equitable, and affordable for physicians to practice medicine in Arizona and stop the loss of doctors and medical services due to unmanageable risk.
We must keep the healthcare gains made with AHCCCS Medicaid eligibility reform (Prop 204 & other measures) and resist the failed public policies that got us into this mess in the first place.
The "hurricane of healthcare" is upon us. The "levees" supporting the healthcare community are at their breaking point. We must act now to assure that our emergency care system is sufficient to meet our emergency care needs in normal times and in crisis. Evacuation is not an option. Hospitals, doctors and nurses cannot do it alone. Government cannot solve this alone. The citizens of Arizona must decide what kind of healthcare they want.
We urge the citizens of Arizona to call or write your legislator and tell them that a D+ grade is unacceptable and that we must protect our access to lifesaving emergency care.
For more information on the Report Card: www.acep.org
Michael Christopher, MD, President, Arizona College of Emergency Physicians
John Rivers, President & CEO, Arizona Hospital and Healthcare Association
Leonard Ditmanson, MD, President, Arizona Medical Association
Thomas Bennett, DO, President, Arizona Osteopathic Medical Society
Joanne E. Navarroli RN, President, Arizona Emergency Nurses' Association
Patt Rehn, RN, Executive Director, Arizona Nurses' Association
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