[down double arrow] Americans are using EDs more often, according to the National Hospital Ambulatory Medical Care Survey. The ED-visit rate rose 26% from 1993 to 2003, while the number of EDs decreased by 12.3%, leading to concerns about crowding and the diversion of patients to alternate facilities. The rate was highest among adults 65 to 74 years of age who lived in nursing homes or other institutions in 2003: 164 visits per 100 persons. In all, more than 50% of visits were for emergent or urgent conditions that needed to be evaluated within 60 minutes, and 14% led to hospital admission. Injury, poisoning, or complications of medical treatment accounted for 35% of visits. Acute illness-respiratory illness, abdominal pain, and chest pain-accounted for most of the rest. In spite of the increased-visit rate and concerns about crowding, the average time patients waited to see a physician in 2003 was 46 minutes, only one minute longer than in 2000. To read the full report, go to http://www.cdc.gov/nchs/data/ad/ad358.pdf.

[down double arrow] Supreme Court says no to medical marijuana. In 1996, under the Compassionate Use Act, Californians could grow, smoke, or purchase marijuana for medical reasons; other states, including Alaska, Colorado, Hawaii, Maine, Montana, Nevada, Oregon, Vermont, and Washington, followed suit. In June of this year, the Supreme Court ruled that the federal government, because of its constitutional authority to regulate the interstate commerce in drugs, may prosecute people who use medical marijuana, even if their state allows it.