Balls and Walnuts
more than you ever wanted to know
ER wait times are getting longer.
(Growl. I’m trying to cross-post this over at DKos but it keeps telling me there’s an error. Error? What error? There’s no error! I’m infallible!
Ahem.)
(Update: Cross-posted!)
A study released today in the online journal Health Affairs demonstrates that the time it takes for a patient to see an emergency physician has increased significantly between 1997 and 2004 (Waits To See An Emergency Department Physician: U.S. Trends And Predictors, 1997-2004). The authors, who looked specifically at adults waiting to be evaluated for acute myocardial infarction (AMI), noted some of the greatest increases were for blacks, Hispanics, and women:
Whites waited a median of twenty-four minutes, while blacks waited a median of thirty-one minutes and Hispanics, thirty-three minutes. Females waited slightly longer than males, a median of twenty-six minutes versus twenty-five minutes.
Below the cut: a few random observations from this doc’s POV.
The authors determined that these racial differences had little to do with race and everything to do with urban vs. nonurban hospitals: “For patients ultimately diagnosed with AMI, the only significant interaction term was urban versus nonurban, with city patients’ wait times increasing 11.6 percent faster per year.” Thus, our urban hospitals are more broken than our nonurban hospitals. Of course, this may still be a symptom of racial bias in the public policies leading to these broken urban hospitals.
I heard about the study this morning, in Joanne Silberner’s report on NPR. It’s a good piece, and brief. I encourage you to listen to it. I was heartened by Dr. Art Kellerman’s comment that Americans are focusing on the long wait times for elective surgery in the UK or Canadian systems, when they SHOULD be focused on wait times for true emergencies, like AMI. That’s when wait times matter most. There, I gather, we don’t fare as well as the folks in the UK or Canada (although Dr. Kellerman doesn’t cite evidence). I’d like to martial the data for you, but it’s late, I’ve spent the day seeing patients in my office, and I’m exhausted. I’m an ENT, not an ER physician, but we get tired, too.
One thing about Joanne Silberner’s report really caught my ear. At the end, Dr. Kellerman apparently felt the need to drive the crisis home: “If you can’t get a single heart attack patient to care in time, how are you going to handle hundreds or even thousands of victims of a terrorist strike?”
At this point, I did a “Whaaaaat?”
How the hell did terrorism enter into this discussion? Is terrorism the ultimate attention-getter? Is it the sine qua non for relevance? Or is it the 21st Century’s equivalent of Godwin’s Law?
Didn’t Dr. Kellerman think the basic message was clear? People are waiting longer to be seen for a possible heart attack. You could die because of our broken system. (Yes, yes, survival data might have given this study greater impact. As it stands, we can only guess. But it’s common sense, I think, that longer wait times will eventually bite us all in the ass.)
But no. He had to invoke the specter of a humongous terrorist attack.
I would love to see the odds ratio: chance of dying from a heart attack vs. chance of dying from a terrorist strike.
(Yeah, yeah, this post is all over the map. But I thought it was an interesting topic and wanted to get it out there for y’all to see.)
D.
I always had to wait 6 hours. White. Female. Crazy.
And don’t forget: Southerner 🙂
Our last visit (potential broken arm) was 7 hours. SEVEN hours. We both finished the novels we brought, traded books and finished those. White guy who was trying to teach his kid to ride a bike. And the x-ray tech turned out to be an ex-student of his, one that had not done well in the class.
Uh oh.
I guess that’s not as bad as looking up from the gurney and seeing a nurse anesthesiologist you gave a D to.
Shortest wait I’ve ever had in an ER is 1.5 hours, but then again, we’ve never had anything worse than broken bones.
Last time I thought I was infallible, I was posting about the topic religion/Dakar cancelled/is God on their side after all, the computer just went down.
Miscarriage, ER, Three Hours.
Guess they didn’t think I was going to bleed out. Dear Butcher kept telling me to pass out on the floor. Or scream in pain, or something.
I like your theory that when in doubt toss in a terrist. Godwin’s law, meet Hoffman’s law.
When the conversation isn’t extreme enough, introduce the terrists. Boom.
One nice thing about being a doc — we never have to wait. Admittedly, one time I was ambulanced in with an incarcerated hernia, and the other time, I called the ER doc in advance, confirmed they weren’t busy, and walked right in. God help us if we really needed them on a busy night.
Suisan, yes, those special effects blood pouches would come in awfully handy 🙂
Kate, thanks. Think the name will stick?
Let’s see, I was just in the ER, but only because it was Dec 26th and I needed to see a dr that day… wait time for a ambulatory, probably non-lifethreatening case of minor urgency: about 20 minutes. This at a pretty big suburban hospital.
The time before that, somewhat ironically for the same condition but of much greater urgency, about 90 minutes I think but I was feverish and the details are fuzzy. This at a very big suburban hospital in the fastest growing city in Canada.
Medical care, like driving, is something with which we all have experience, and something on which we all believe we have informed opinions. And because it’s such a crucial part of our lives, it is highly political.
I don’t get the terrorist thing, though.
I heard the piece on NPR, too. Very interesting.
The last ER I was in they had no room for my gurney, so they stuck me up against a hallway wall.
At least they treated me properly, though. I’m still considering legal action against the ER I went to before that, where they improperly treated my wound and later discharged me with a raging fever and infection…
Four People in an Emergency Room, none emergencies, tons waiting to see THEIR doctor. Four people to check you in, not one system can’t have that, one to give you a bill of rights, five people, we haven’t seen anybody yet, two leave. One comes back later, seen pain anxietyforget it about it, heart monitor, wasted time, guy was jostled early in the morning with past complaint of same not seen for complaint in years. Cost about $500 bucks treatment nothing. Sinus lady the other one that left, probably neck problems but no one even touched her neck I guarantee it, five years no results, never did anything for her. No compassion, no bedside manner, didn’t even fake laughing at a bad joke, here it comes THE SYSTEM IS RIGGGGGGED, and we have no accountabilty no one watching the store that cares. Republicans should go to any hospital and see the long lines now. If we had health care for all all this would be reduced, preventive care, not major care.
And always be nice to your patients no matter what time it is…