Puerto Rico Press Release


Embargoed For Release at 11 am (ET)
January 16, 2014

Media Contact:
Laura Gore, 202-370-9290 
Follow ACEP on Twitter @emergencydocs


WASHINGTON — Lengthy emergency department wait times and a medical liability environment that is discouraging physicians and other medical providers from practicing are two serious issues facing Puerto Rico, according to a new state-by-state report card on America’s emergency care environment, released today by the American College of Emergency Physicians (ACEP). 

Puerto Rico has increased (by 25 percent) the number of registered nurses since 2009 but continues to have extremely low rates of medical specialists, including emergency physicians and surgeons. Compared with the states, Puerto Rico has less than half the rates of emergency physicians and key specialists, including neurosurgeons and hand surgeons. Puerto Rico also has seen slight increases in the rates of psychiatric care beds and staffed inpatient beds, but two hospital closures in 2011 likely are contributing to a high hospital occupancy rate.

“Emergency patients can expect to wait 13 hours to be admitted to a hospital room,” said Dr. Daniel Munoz, president of the Puerto Rico Chapter of ACEP. “This is in part because of Puerto Rico’s medical liability environment, despite numerous efforts to address the problems. For example, the number of insurance companies writing policies in Puerto Rico is among the lowest in the nation. Advancing medical liability reform would go a long way to help retain medical providers.”

In the category of Public Health and Injury Prevention, Puerto Rico has decreased the proportion of alcohol-related traffic fatalities and continues to have a high rate of seatbelt use among front-seat occupants, surpassing the nation’s rate.

“These are positive trends, but we need to continue to reduce the rates of preventable deaths by conducting public education efforts, for example, to reduce the number of alcohol-related traffic fatalities,” said Dr. Munoz. “In addition, to improve the overall health of our citizens, Puerto Rico must address such issues as the critically low rates of immunizations among older adults.”

The Report Card has recommendations that include:
  • Reform the medial liability environment to reduce health care providers. Reforms that discourage frivolous lawsuits, such as pretrial screening panels or case certification, would be important steps in reducing Puerto Rico’s litigious environment.
  • Investigate additional reasons for physician and other medical provider shortages, such as the loss of talented physicians to the mainland. These shortages affect all aspects of health care, from routine preventive care and emergency care to the ability to prepare adequately for disasters. 
  • Encourage medical facilities to speed up the adoption of technologies, such as use of electronic medical records and computerized practitioner order entry. This will help reduce medical mistakes.
According to the Report Card, much of the Disaster Preparedness data for this Report Card were collected in a state-by-state survey of disaster preparedness officials, but the survey was not completed by Puerto Rico.

“America’s Emergency Care Environment: A State-by-State Report Card – 2014” evaluates conditions under which emergency care is being delivered, not the quality of care provided by hospitals and emergency providers. It has 136 measures in five categories: access to emergency care (30 percent of the grade), quality and patient safety (20 percent), medical liability environment (20 percent), public health and injury prevention (15 percent) and disaster preparedness (15 percent). While America earned an overall mediocre grade of C- on the Report Card issued in 2009, this year the country received a near-failing grade of D+.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.


# # #


Share This Info

Contact Congress

Take federal action and get your national officials involved

Public ACEP Members