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Qualitative Health Research, Vol. 11, No. 2, 161-178 (2001)
DOI: 10.1177/104973201129119028

When the Visit to the Emergency Department is Medically Nonurgent: Provider Ideologies and Patient Advice

Nurit Guttman

Department of Communication at Tel-Aviv University, Department of Family Medicine at the Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersy

Myra Shoub Nelson

Department of Family Medicine at the Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey

Deena R. Zimmerman

Urgent Care Center (TEREM) in Israel

It is estimated that more than half of pediatric hospital emergency department (ED) visits are medically nonurgent. Anecdotal impressions suggest that ED providers castigate medically nonurgent visits, yet studies on such visits are scarce. This study explored the perspectives of 26 providers working in the EDs of two urban hospitals regarding medically nonurgent pediatric ED visits and advising parents or guardians on appropriate ED use. Three provider ideologies regarding the appropriateness of medically nonurgent ED use were identified and found to be linked to particular communication strategies that providers employed with ED users: restrictive, pragmatic, and all-inclusive. The analysis resulted in the development of a typology of provider ideological orientations toward ED use, distinguished according to different orientations toward professional dominance.


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