Emergency Rooms and STDs

A new medical study raises an important question: should anyone who is seen in an emergency room be automatically screened and treated for other essential problems and conditions that in the end affect society as a whole—such as sexually transmitted illnesses? Some experts are saying a visit to the emergency room should mean much more to many patients besides ice, ace wraps, and sutures. “Unfortunately without a primary care physician they are missing out on a lot of important services,” says second-year pediatric resident Dr. David Kessler and supervising physician Dr. Karin Sadow at Mt. Sinai Hospital. They recognized that once a patient is finally seeing a doctor in the E.R., for whatever reason, while it’s certainly not an ideal or inexpensive place to have a patient visit, at least they’re there. And maybe, screening for other health issues that are costly to society as a whole makes sense. The researchers had young males coming in for any reason, complete an anonymous questionnaire on sexual behavior. They also performed urine-screening tests for gonorrhea and Chlamydia. They found a high frequency of high-risk sexual behaviors and sexually transmitted illness among those who use the E.R. as their only means of health care, and did not go to a regular doctor--like Knemal Moore, who doesn'’t have a doctor, came in for a sore throat and didn’'t know he was, by chance, also carrying a sexually transmitted illness.

“It took me by storm because I never had to deal with something this dramatic in the hospital before,” says Knemal. Dr. Kessler says, “An ounce of prevention is worth a pound of cure and if we can screen people for sexually transmitted illnesses early on, we can prevent a lot of later complications, which means increased ER visits, increased adverse health effects for the patient and increased cost to the whole system.”

So should doctors screen for not only STD’s, but other conditions as well? Dr. Sadow says, “Further studies are definitely recommended at this point just to decide what is cost effective, I mean is it cost effective just to screen this population, it may or may not be, once again we have limited resources.”

Dr. Kessler adds, “With chronic asthmatics starting control medications from the emergency department actually saves money in the long run and spares return visits to the hospital.” Knemal will say he certainly got the benefit personally. “I’m actually glad that I found it out now, it would have gotten worse.”