Trip to A&E? You’re often better off elsewhere
Many A&E departments in Switzerland are overcrowded and pushed to their limits. Often because too many people go there with complaints that aren’t medical emergencies. We pinpoint four typical cases.
Because A&E caters for multiple medical specialities under one roof, is open 24/7, and doesn’t require an appointment or referral by a specialist, more and more people prefer to go there rather than their family practice. Even when it’s not really necessary – and primarily in the evening or at the weekend when medical practices are closed. In 2021 alone, almost 686, 000 cases were treated in A&E departments in Switzerland.
The problem is that even trivial medical complaints, such as tick bites or a sprained ankle, occupy staff and resources that are more urgently required by real emergencies, such as strokes or heart attacks. There are many reasons for unnecessary A&E visits. Some people forget to get a prescription during their medical practice’s opening hours, while others worry that their ailment may be more serious than they first thought. If you sometimes need help interpreting your symptoms, the Sanitas Medgate app gives you 24/7 access to rapid help with medical queries.
Four typical cases that aren’t emergencies
Ask an expert
Mr Bingisser, when I go to A&E in Switzerland, how sure can I be that I will get fast treatment when I need it?
If it’s a real emergency – very sure! Based on various criteria, we sort patients quickly and accurately directly at the door. It’s not first come, first served: we prioritise by urgency. A person who comes with chest pain or breathing difficulties will be seen first. Mortality after a heart attack or stroke has fallen dramatically in recent decades. If I have nine false alarms out of ten cases in A&E, but can save a person’s life, that’s a great success! So all the discussion about overcrowded A&E departments should not put an emergency case off coming to us at all.
Is convenience or ignorance the reason why A&E waiting areas fill up with trivial cases?
If everyone was able to interpret and treat their symptoms correctly, doctors would be out of a job. The problem isn’t the individual patients, but the healthcare system itself. Overcrowding in A&E is caused by the severely limited opening hours of medical practices, and the fact that many family doctors are no longer adequately trained in emergency medicine. And many people don’t have the health education needed to distinguish between an emergency and a minor injury. That’s inefficient. Although being treated in A&E isn’t as expensive as seeing a specialist, it is significantly more expensive than seeing a family doctor.
How can you tell if it’s an emergency?
Breathing difficulties, chest pain, severe pain in the upper abdomen, acute, very severe headaches or functional impairments such as paralysis should always be taken seriously. Sudden dizzy spells are especially dangerous for older people. Ask yourself the question: Am I young and otherwise healthy? If the answer is yes, most symptoms can usually wait until your medical practice is open the next day.
Professor Roland Bingisser is chief consultant in the A&E department at Basel University Hospital.