Choosing better, US style

Short White Coat blogger Ishani Ganguli marvels at a frank UK ad (advert?) discouraging people with non-serious illnesses or conditions from clogging up the emergency room. It shows a line of people who shouldn't be there. At the end is a wreath, representing a heart attack victim who should have been first in line.She wonders aloud why we couldn't have that kind of campaign here and answers that problems include access to primary care, the perception that going to the ED would be quick, and that primary care referred them to the ED.These factors are all legitimate, but there's more to the story. Emergency departments can be profitable and are a major feeder for inpatient admissions, so hospitals advertise them. You don't have that in the UK. That advertising also leads to the perception that the hospital is a better place to be seen, so even patients who could get access to their primary care physician don't try.My health plan (Blue Cross) and others have what are euphemistically referred to as "demand management" services. In my case I can call and speak with a nurse who can steer me in the right direction, whether toward self-care, the emergency department, primary care, a specialist or the pharmacist. I'm not sure these things really save the health plans any money, but I also don't know whether the UK ads work.