EVERY person presenting to the ER should be triaged by a mid-level practitioner (PA or NP).
If their condition is not emergent, the should be offered the choice of: a) paying the entire bill w/ cash/credit card at the time of service, or b) told to see their primary MD in the morning.
People that don’t pay for their care (medicaid) anyway are the ones clogging the ER, and they are the ones that think nothing of raising hell for having to spend HOURS waiting to be seen for their mild case of the sniffles.
The ER is NOT your doctor’s office!
I'd like to add:
EVERY person presenting to the ER should be triaged by Immigration and Border Enforcement. Our citizens are denied service, or recieve a lesser level of service, because of all the illegal Mexicans gumming up the system. Get rid of them and you remove a big part of the problem.