I volunteer on a med/nursing unit at a large local health system, where I round on patients and help with their comfort and needs, or I just help set up different patient rooms or help stock and resupply materials across the floor. Being around patients has made me notice something I read about later and couldn’t stop thinking about: a lot of hospital and ER visits didn’t have to happen at all.

The Agency for Healthcare Research and Quality looks at my finding directly. They report that an estimated 13% to 27% of ER visits in the U.S. could have been handled in a doctor’s office, clinic, or urgent care, which they estimated could save around $4.4 billion a year. These are visits for conditions that are preventable or treatable with good primary care, things that didn’t need an emergency room.

When I shadowed a foot and ankle podiatrist, I saw this play out in person. A lot of what the doctor was treating were conditions that had quietly gotten worse over time, partly because people didn’t have consistent access to basic care earlier. By the time they came in, the problem was bigger than it needed to be because they previously did not have access to treat it because of things such as a lack of money.

That’s the pattern I keep seeing. We tend to wait until something becomes an emergency, then deal with it in the most expensive, most stressful place possible. It’s like ignoring a small leak until the ceiling caves in and everything else just goes horribly.

The fix isn’t really about emergency rooms; it is more about everything that comes before patients reach them. If people had a regular doctor, could afford a visit, and could get in to be seen when a problem was small, a lot of those emergency visits would never happen.

I don’t think the answer is to tell people to stop going to the ER. People go to the ER because they don’t have a better option. The real answer is giving them that better option earlier through prevention, which will always be cheaper and easier on everyone.