A Jan. 17 Metro story reported that local hospital officials said they didn't know the District was discussing turning D.C. General Hospital's emergency room into an urgent-care center.

But this plan was discussed at a mayor's summit on Jan. 3 at which the primary care providers supported the idea as a way to decrease ER visits and costs, as well as patient waiting times, across the city. The notes of that summit were distributed to 3,000 people Jan. 14 in the D.C. Primary Care Association's daily information update.

Another charge in the article -- that the D.C. government is responsible for the problems of D.C. hospital emergency rooms -- is debatable. Nationally, ER use is up as the number of uninsured patients has increased, and ERs are the only places uninsured people can go for care. And according to the D.C. Hospital Association, the District's 21.85 percent nursing vacancy rate is the "primary reason that D.C. hospitals are unable to staff additional beds, which can lead to overcrowding of ERs and increased ambulance diversion." The fate of D.C. General's ER will have an effect, but the issue is complicated and the city is not solely responsible for the crisis in ER care. Nor can the government solve it alone.

The District's program for the uninsured, the D.C. Healthcare Alliance, is slowly but surely moving patients into primary care, where illness can be prevented or controlled and hospital use decreased. The alliance, however, is threatened by the weak economy and the resulting decrease in tax revenue, as well as by the bankruptcy of Greater Southeast Community Hospital.

SHARON A. BASKERVILLE

Executive Director

D.C. Primary Care Association

Washington