A visit to the Emergency Room has never been a quick affair, at least not while I have been alive. But, the waiting time seems to have reached a serious level that needs immediate attention. The issue is so convoluted and so complex that it is hard to make any sense of, but there are a few places where the system can certainly be fixed.
On a recent visit to the E.R. for a fairly serious ailment, I was told that the wait time would be at least five to six hours and quite possibly more. After two hours we had still not even been seen by a triage nurse and finally left to wait it out at home until a doctor’s visit could be made. I did ask whether going to the other hospital in town might be quicker and was told that the other was completely filled to capacity and that patients there were being sent to this hospital. I might have thought this was an extreme case if last summer had never happened.
Last summer I took a toddler who was dehydrated, vomiting, and had a fever of 104 to the E.R. We waited four hours for the child to be seen. Four hours with a child that young and in that condition was absolutely unreasonable, but there were those even worse off. One man had been diving into a lake and struck rocks, causing quite a few large, open wounds, as well as some damage to his head and neck. They stuck him in a wheelchair and put a band around his neck and left him there in the waiting room. He waited even longer, and was still there six hours later when we left. Another man was crumpled over in pain, trying not to let the other patients see him crying as he waited hour after hour.
I read about a woman in 2006 who had been waiting for hours in an E.R. waiting room while having chest pains. She died of a heart attack while waiting to see a doctor. And then there was the woman in Arizona in early 2007 who waited almost 24 hours for help in the E.R. before they had time to see her. What is going on in this country?
One of the basic problems is that the federal law requiring that anyone entering the hospital be seen regardless of any circumstances is well intentioned but flawed. The law is now abused by people seeking medical care that can’t pay for it, knowing that they have to be seen anyway. And for emergency situations, that is understandable- insurance or no, an emergency should be taken care of. But there are many who now use the E.R. as their GP, going for colds, sinus infections and other routine reasons that would go away on their own. And yes, some illegal aliens go because they know they will be seen even with no ID and no medical records. All of this is an abuse that the system as it is now simply can not handle.
But, there is another reason behind all of this that is much more insidious. Having been through this scenario a few times, and having asked why the wait was so long, it was explained that there weren’t many doctors and certainly not enough for everyone to be seen in good time. Really? There aren’t enough doctors? Yes. In the country hospital I visited, there was one E.R. doctor on staff for what was a holiday weekend. One.
Exactly why would anyone have only one doctor manning an E.R.? Why would a larger hospital have only a handful on duty in a large city hospital when they already know that they are often full to capacity? It’s the same reason that doctor’s appointments are hard to get and that doctors make such high salaries. There are not enough doctors by design.
In the U.S.S.R., doctors were plentiful, with a delightfully low patient to doctor ratio. This of course led to lower salaries for doctors. This is not going to happen in the U.S. anytime soon. The American Medical Association strictly limits the amount of Americans who can become doctors each year, specifically to keep the prestige, and salaries, of doctors as high as possible. And if this interferes with Americans having better and more affordable access to healthcare, well, screw ’em.
The AMA takes it upon itself to decide how many physicians we need and will need in the future. And if they make a mistake and we end up the way we are now? Oops. I have to wonder why the AMA is not being protested by patient groups, or being called before congress to defend their actions. But, it doesn’t take long to figure that one out. As Deep Throat once said- follow the money. Money buys a lot in this country, and it is certainly buying a guilt-free continuance of the AMA. Congress will not be investigating anytime soon, there will never be an anti-trust suit, and no law will ever cross such a rich and powerful organization. If you want to be seen for an emergency, I can only suggest planning your emergency in advance and making an appointment to be seen for it. Unless of course you want to be found dead in a chair in an E.R. waiting room somewhere.
