The provider-in-triage system is supposed to shorten wait times by allowing physicians to quickly assess patients, often in a span of two minutes, and order diagnostic tests to be performed while the patient waits. But the system often leads to physicians ordering a slew of unnecessary tests for diagnoses they could have ruled out with a slightly longer, more thorough initial exam, Dr. Corl wrote. The tests end up costing patients thousands of dollars.
Provider-in-triage can also increase the likelihood of a misdiagnosis, wrote Dr. Corl. Physicians who see test results before meeting a patient may become biased toward the wrong diagnosis. Yet hospital executives like the system, Dr. Corl wrote, because it allows the hospital to profit off almost every patient in the emergency department.
To fix the problem, Dr. Corl suggested physicians call upon organizations such as the American College of Emergency Physicians to adopt policy statements against the provider-in-triage model. Hospitals must act as well by providing emergency departments with sufficient resources, such as staff and patient beds, to provide quality care.
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