# Is it possible to have a hospital w/o an ER? **URL:** \ **Category:** Factual Questions\ **Created:** [February 20, 2007, 1:25am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895 "2007-02-20T01:25:28Z")\ **Posts on this page:** 12\ **Page:** 1
**Author:** ![sdguy](https://avatars.discourse-cdn.com/v4/letter/s/8dc957/32.png) [@sdguy](https://boards.straightdope.com/u/sdguy)\ **Post date:** [February 20, 2007, 1:25am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/1 "2007-02-20T01:25:28Z")
I read in the newspaper that a few hospitals in LA have closed due to the high cost of treating uninsured people. I was thinking since most of these uninsured people come in to the hospital via the ER why not simply shut down the ER instead of the whole hospital. Since you have to register to go into a hospital if it isn’t an emergency, the hosptial could just not take uninsured patients. I know they have children’s hospital with ERs that don’t take adults and I’ve even seen women’s hospital’s with ERs so it must be possible to limit the choice. So can you have a fully operatrional hospital minus the ER part? ---
**Author:** ![Baffle](https://avatars.discourse-cdn.com/v4/letter/b/dec6dc/32.png) [@Baffle](https://boards.straightdope.com/u/Baffle)\ **Post date:** [February 20, 2007, 1:34am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/2 "2007-02-20T01:34:45Z")
A better option might be to provide health insurance to everybody. ---
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [February 20, 2007, 1:38am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/3 "2007-02-20T01:38:29Z")
I do not work in medical but I see a few problems. 1. The ER feeds the rest of the hospital with patients. 2. Patients in that hospital (not inpatient at the moment) may need ER services and it make no sense to send them to another hospital for stabilization and back again. 3. ER services may be more integrated than you think with the rest of hospitals system. 4. I have gone to a hospital without an ER, demanded to be admitted and it worked. I don’t want to go into details but it was a prestigious hospital that tried to block access via that router. There are ways around that. There are hospitals without an ER though. There is a physical rehabilitation hospital in this general area that I don’t think has an ER. ---
**Author:** ![thelurkinghorror](https://avatars.discourse-cdn.com/v4/letter/t/7c8e57/32.png) [@thelurkinghorror](https://boards.straightdope.com/u/thelurkinghorror)\ **Post date:** [February 20, 2007, 1:38am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/4 "2007-02-20T01:38:41Z")
I know of at least one which doesn’t have an ER, but then this depends on what “fully operational” means in the OP. It doesn’t have every department. This is a major hospital, but it is paired with another hospital close by, which does have ER. ---
**Author:** ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)\ **Post date:** [February 20, 2007, 1:40am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/5 "2007-02-20T01:40:38Z")
Sure; there are hospitals -both public and private- here that completely lack an accidents and emergency section - if you wander into one of these with, say, a severed finger, they’ll just call an ambulance for you (well, they might offer first aid if it looks like you’ll die before the ambulance arrives, but that could also happen in a department store) ---
**Author:** ![Ca3799](https://avatars.discourse-cdn.com/v4/letter/c/9f8e36/32.png) [@Ca3799](https://boards.straightdope.com/u/Ca3799)\ **Post date:** [February 20, 2007, 2:04am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/6 "2007-02-20T02:04:19Z")
My hospital does not have an ER. We will stabilize and transfer anyone we cannot treat. ---
**Author:** ![bouv](https://avatars.discourse-cdn.com/v4/letter/b/bc8723/32.png) [@bouv](https://boards.straightdope.com/u/bouv)\ **Post date:** [February 20, 2007, 3:51am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/7 "2007-02-20T03:51:57Z")
When I was a traveling biomedical technician, I went toi a very rural hospital that barely had an ER. It was literally one room, two beds, and was only open from like 7 AM to 11 PM, and the second shift was only covered by a PA, not a doctor (though one was on call.) ---
**Author:** ![St.Urho](https://avatars.discourse-cdn.com/v4/letter/s/8e7dd6/32.png) [@St.Urho](https://boards.straightdope.com/u/St.Urho)\ **Post date:** [February 20, 2007, 4:05am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/8 "2007-02-20T04:05:40Z")
In Colorado, general hospitals are required to provide emergency services. However, the state also licenses Psychiatric, rehabilitation, and long-term care hospitals. [http://www.cdphe.state.co.us/hf/static/hospital.htm](http://www.cdphe.state.co.us/hf/static/hospital.htm) Here’s a couple of hospitals in the Denver Area that don’t have ERs: [National Jewish Medical & Research Center](http://www.nationaljewish.org/) [The Medical Center of Aurora- North](http://www.auroramed.com/CustomPage.asp?guidcustomcontentid=1BC3E0B2-F91D-11D3-A2CA-00508B1245EF) If you show up at Aurora North, for example, they typically won’t let you into the building. They’ll call 911 and security will wait with you until we (the ambulance) showed up. St. Urho Paramedic ---
**Author:** ![FRDE](https://avatars.discourse-cdn.com/v4/letter/f/e68b1a/32.png) [@FRDE](https://boards.straightdope.com/u/FRDE)\ **Post date:** [February 20, 2007, 8:41am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/9 "2007-02-20T08:41:41Z")
As Mangetout said, in the UK there are plenty of hospitals without an Accident & Emergency unit ( British for ER ). For some strange reason people prefer going to the A & E rather than going to their GP, the rational response was to close the A & Es. ---
**Author:** ![Randy\_Seltzer](https://avatars.discourse-cdn.com/v4/letter/r/ee7513/32.png) [@Randy\_Seltzer](https://boards.straightdope.com/u/Randy_Seltzer)\ **Post date:** [February 20, 2007, 8:53am UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/10 "2007-02-20T08:53:54Z")
In California, any hospital with more than _x_ beds must, by law, have an ER. (I believe it’s 25, but I’m not sure.) Contrary to what someone (can’t remember) posted above, no hospital in the US would want to have an ER, if it could be avoided. Financially, the ER is a net loser in any American hospital, because the uninsured will use it as a free health clinic. Scanning the list of the SS#s of ER admittees, one is confronted with a lot of “000-00-0000”. ---
**Author:** ![Sal\_Ammoniac](https://avatars.discourse-cdn.com/v4/letter/s/8dc957/32.png) [@Sal\_Ammoniac](https://boards.straightdope.com/u/Sal_Ammoniac)\ **Post date:** [February 20, 2007, 3:42pm UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/11 "2007-02-20T15:42:35Z")
[QUOTE=Randy Seltzer] Contrary to what someone (can’t remember) posted above, no hospital in the US would want to have an ER, if it could be avoided. Financially, the ER is a net loser in any American hospital, because the uninsured will use it as a free health clinic. [/QUOTE] Not true. As **Shagnasty** pointed out above, without the ER, you lose your main artery for filling inpatient beds with paying patients. The economics will be different for every hospital, and not every hospital is plagued by the uninsured using the ER as a free health clinic. ---
**Author:** ![anson2995](https://avatars.discourse-cdn.com/v4/letter/a/c77e96/32.png) [@anson2995](https://boards.straightdope.com/u/anson2995)\ **Post date:** [February 20, 2007, 5:01pm UTC](https://boards.straightdope.com/t/is-it-possible-to-have-a-hospital-w-o-an-er/392895/12 "2007-02-20T17:01:46Z")
One of the hospitals here did not have an obstetrics department, but found themselves occasionally having to deal with women who showed up in labor. They eventually created one since they were delivering babies anyway. I suspect that a hospital without an emergency department would find itself drawn in the same direction.