Friday, September 3, 2010

Emergency Room Wait Times

I’ve noticed some strange messages on billboards in our area: Hospitals are advertising their emergency room (ER) wait times.
Pulaski Community Hospital and Montgomery Regional Hospital have put up some big signs showing their emergency room wait times, in real time. The big billboards have lights that form numbers indicating the current wait time. The last time I drove by, the sign was showing a 14 minute emergency room wait time. They also have signs telling us that we can text them to get the latest wait time. Yes, you can text in to get the emergency room wait time, kind of like texting the bank to get your account balance.

This is very odd. Why would hospitals advertise their emergency room wait times? Why would anyone care what the ER wait time is?

When I called the hospital administrative office and asked about this, I was told that the reason for doing it is that they know people have choices, and they want to show that they are putting patients first. The person also explained that the wait times shown on the signs are a four hour rolling average.

Let’s think about this. If someone has a medical emergency, does the emergency room wait time matter to him? A person having a heart attack, for example, is not going to say, “Oh, the wait time is too long; I’ll go later, or maybe tomorrow.”

I can imagine the conversation. Husband: “Dear, I think I’m having a heart attack. I have bad chest pain, I’m sweating profusely, and there’s this funny feeling running down my arms to my fingertips. We’d better go to the emergency room.” Wife: “Let me text in for the wait time. Oh, look, there’s a long wait. Can you hold off awhile? We’ll go later when the line is shorter. Or I could check with the other hospital to see what their wait time is, if you want.”

No, you don’t do that; you go as fast as you possibly can.

And once you get there, it’s not “first come; first served.” The emergency room staff decides which cases are the most urgent, and those cases get treated first, while the less critical emergencies may have to wait awhile. I learned this first hand when my daughter was about four years old, fell and cut her forehead, and we went to the emergency room. Even though she had a bad gash, it wasn’t bleeding much, and we were told that other cases were more urgent, so we had to wait. Someone having a heart attack will go right in.

Yes, I know the whole story about the “uninsured” using emergency rooms for their primary care. When little uninsured Johnny has a fever, his parents take him to the emergency room, where all comers are required by law to be treated, no matter what.

And that was one of the major problems with the health care system. The uninsured were using the emergency room as their family doctor, clogging it up with routine cases, and having to wait for hours while the true emergencies were taken care of. Not only was this a problem because of the inefficiency, we were told, it was also a problem because of the expense.

Emergency rooms are very costly, and using them for non-emergencies made that care very expensive, pushing up costs for everyone. It was one of the major problems that was cited as to why we had to vastly overhaul the entire health care system. We had to get those routine cases out of the emergency room, so we wouldn’t bankrupt the system. Obamacare was going to fix all of this.

So, I ask again, why are hospitals, right now, advertising their emergency room wait times?

There can be only one reason. They must think that by advertising their wait time, they can entice more people into using the emergency room, and to use their ER instead of another one. But this only makes sense for non-emergency cases, where people have a choice of going now or later, or not at all.

The inescapable conclusion is that the hospitals putting up such signs are trying to attract as many non-emergency cases to their ER as possible.

There’s a skunk in the woodpile.

Here we have hospitals actively working to make the problem of abuse of the emergency room worse. They are actually promoting it! They apparently want to get as many of the uninsured as possible into their ER.

Then it must not be a problem. Forget everything you heard about the problem of the uninsured and the ER. Now that Obamacare has passed, we learn that it was not true.

Wait, could it be something else? Could it be ----- ? No, it couldn’t be that some of the obscure provisions in the 2400 page byzantine Obamacare bill are having unintended consequences. Maybe buried in there somewhere are some provisions regarding the uninsured that give hospitals a financial incentive for using the ER for routine cases. Could Obamacare have made this problem worse? Is that why we are starting to see those ER wait time signs?

Jessee Ring
Aug. 24, 2010


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  2. When you have waited 3-4 hours to see an ER doctor... a billboard as shown would be understandable.