LAUSR

nary artery disease and other conditions. This drop in hospital admissions might be seen as a hopeful sign of decreasing costs in US health care were it not accompanied by a major increase in ED visits. We appear to have an insatiable desire for immediate acute care. Given the low overall hospital admission rate, many of these patients likely would have been more appropriate for office visits rather than ED. However, as we know, most physician offices are open Monday through Friday, 9 AM to 5 PM, and many do not have ability to schedule additional patients for acute care at the last minute. The result is a rational decision on the part of the patient to seek care in a place that is always open and has excellent immediate access to advance screening and specialty referral. Ultimately this decision is likely to result in long waits for the patients, higher expenses for systems and patients, and more unnecessary care. The growing lack of access to timely primary care in the United States has many ramifications; increased ED visits, identified in this study,1 may be another one.