So, here's a nice thread that Future EM Resident Graham Walker started about telling patients, nicely, that they don't have an emergency:
"Hey, good news! I talked about your case with the attending, we reviewed your story and physical exam findings, and we both agree that you don’t need any blood tests drawn, or a trip down to the radiology department for some xrays. In fact, what you’ve got will almost certainly get better on its own, though here are the warning signs to watch out for..."
Then later (or earlier) you can mention, "You know, we triage patients so that complaints like yours today aren’t seen as fast as the life-or-death cases. You might save time, and get seen faster, in a primary care clinic. What? You don’t have insurance? You can still be seen in the resident clinic... And as you build up a relationship with these clinic doctors, they can give you more information on your condition, do routine testing to nip new problems in the bud... it really saves time and peace of mind, in the long run..."
This won't please everyone (especially in Manhattan, where no patient likes to think they overestimated an "emergency.") Some people feel entitled to testing because they waited forever. Some patients want a medical-sounding diagnosis for every ache or sniffle.
I tell them I see emergencies all the time, I love them, I go out of my way to look for them, but hey, it's *a good thing* I don't think they're crashing -- they should be happy and reassured. And while it’d be great to pin a diagnosis on every little thing, I'm not a rheumo-neuro-psychiatrist... my job is to find emergencies, and they don't have one.
I like the comments from a mom who didn't exactly know what 'a good sat' was, and the reader who added that a minor cold might get worse in an ED full of germs.
Further reading: a brief discussion of the origin of the name Gomer (were there ERs in the Biblical times?)