title: Primary care in the emergency department -- an untapped resource for public health research and innovation.
abstract: With rising patient volumes and increasingly complex cases, the specialty of emergency medicine faces a growing array of challenges. Efforts have been made to improve patient throughput, yet little attention has been directed to the increasing amount of primary care delivered in emergency departments (EDs) for chronic disease states such as hypertension and diabetes. Management of chronic medical conditions is traditionally seen as beyond the purview of the ED and emergency physicians tend to defer critical aspects of related patient care to other components of the healthcare continuum. As a result, vulnerable patients are often forced to navigate exceedingly complex and fragmented systems of care with little guidance, which often leads to inadequate treatment and exposure to increased risk for development of potentially avoidable complications. As evidenced by our experience with hypertension in an under resourced community, there is a crucial need for emergency physicians to espouse their role as providers of healthcare across the acuity spectrum and lead the way in defining regionally relevant solutions to better manage patients with chronic medical problems.
authors.affiliation: Department of Emergency Medicine, Wayne State University School of Medicine, Detroit Medical Centre, UHC Suite 6G, 4201 St Antoine St, Detroit, Michigan, 48201, USA. abrody@med.wayne.edu.
authors.forename: A M
authors.initials: AM
authors.lastname: Brody
authors.affiliation: Department of Emergency Medicine, Wayne State University School of Medicine, Detroit Medical Centre, UHC Suite 6G, 4201 St Antoine St, Detroit, Michigan, 48201, USA.
authors.forename: E
authors.initials: E
authors.lastname: Murphy
authors.affiliation: Division of Translational Research and Clinical Epidemiology; Department of Medicine; Cardiovascular Research Institute, Wayne State University, Detroit, Michigan, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Flack
authors.affiliation: Department of Emergency Medicine; Cardiovascular Research Institute, Wayne State University, Detroit, Michigan, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Levy