Patients Leaving Emergency Departments Without Being Seen by a Physician

Otto J. N. Kunst, MD
JAMA. 1992;267(2):231. doi:10.1001/jama.1992.03480020041015.
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To the Editor.  —I read with interest the articles1,2 and editorial3 regarding patients leaving public hospital emergency departments without being seen by a physician and the resultant failure to provide necessary medical care, particularly to the indigent. This becomes even more interesting when juxtaposed to a brief Centers for Disease Control article4 regarding the 33 million Americans lacking health care coverage.Has anyone considered how much more strain will be placed on the health care provision system if a universal health care system is instituted and 33 million more potential patients are dumped on the system? How many more delays and outright failures to provide necessary care will then result?The only alternative would appear to be an expansion of the health care system, both in terms of physical facilities and equipment, physicians, nurses, and other paramedical personnel. However, a major underlying motive of many supporting


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