What Is An Emergency Room Meant For Anyway?
Posted by Sonny Saggar on Sun, Jan 22, 2012 @ 01:49 PM
Urgent Matters THE blog for 'The Non-Emergency Room'.
OK this is another blant (blog-rant, my most recent neologism). Although I'm an entrepreneur, I'm still a physician and I as an internist, urgent care physician and al
so an emergency physician. I've been working ER since 1995, when I first worked in the beloved A&E (Accident and Emergency) Department in Stoke Mandeville in England. I wonder how they're doing...
Anyway, nostalgia aside, this post is all about what should be seen at an ER and what shouldn't. Why is this important? I'll tell you why. You may recall about 10 years ago there was this thing called 'ER Overcrowding', when all the ERs were at full capacity, when ambulances had to park in the shoulder of highways because they couldn't find an ER that had a room for their patient, because so many ERs were on diversion. As a result of that, a lot of tax-collected funding (federal, state and city) has been diverted to hospital systems that bemoan their overcrowding issues. This continues now, although the overc
rowding isn't a problem any more. Another solution was the advent of urgent care centers and retail clinics, which cater to the 85% of present-day ER cases that are not actually emergencies.
So now there's a bit of a revenue challenge. How can these privately owned hospital systems get more people to come to their facility (to their ER) rather than to the competition's (neither system having overcrowding problems any more)? In all this frenzy of competitive marketing, many have lost sight of what the 'E' in ER actually stands for. Many have forgotten that the 911 service, which is to be used for getting people quickly to ERs is not supposed to service departments that are profiteering because they offer some special promotions.
The latest promotion? Some hospital executives have decided, in their infinite wisdom, that if someone with an EMERGENCY needs to visit the EMERGENCY room, should first get online and get in quicker (yes, there's a company called InQuicker.com that does just that for the hospital that participates in this oxymoronic 'solution'), instead of calling 911.
It seems to me that if someone says they have chest pain or can't breathe or stroke-like symptoms, the online form should stop them and say "stop what you're doing and call 911 you idiot".
Similarly, if someone says they have a sore throat, or a cough or burning with urination or a small cut or a possibly broken foot, the online form should stop them and say "stop what you're doing and go see your primary care doctor or visit and urgent care or Walgreens clinic you idiot".
There you go, I've got it: hospitals should continue using InQuicker.com to verbally abuse patients who decide to use it for an ER visit. Perfect. What a great service to the community that would be. I take it all back, don't fire InQuicker.com - let's use it in every ER in the country! 
Seriously though, do you really want to take your husband in for a possible heart attack only to find that the ER doctor and nurse are busy rushing to the bedside of someone who has registered online via InQuicker.com to attend to his sore throat? Do you think it's socially responsible for people to use the ER for non-emergency conditions? We have many other places for that. In England, where taxpayers pay for medical care, us Emergency physicians were very comfortable with metaphorically throwing people out of the department because they came in with stuff which was inappropriate, e.g. foot pain for 3 years, migraine headaches, sore throats, sinusitis, bladder infections and all sorts of other NON-emergencies. It was considered a very antisocial thing to do if you went to the EMERGENCY department with something that quite obviously shouldn't be taking emergency staff away from the critical patients.
People, on behalf of all emergency physicians, nurses, techs and secretaries, as well as on behalf of all emergency patients and their families, please stop using the ER if you don't have an emergency. Don't you dare go online to register to be a patient in the ER, unless you want the unspoken wrath of the staff, not to mention other patients in the waiting room who just rushed in for their problem (appropriately) rather than logging on to the internet first and getting a 'guarantee' that they'll be seen ahead of everyone else. If you have time to do that, please go to a Walgreens/CVS or urgent care, assuming you can't see your primary care or family physician first.
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