Situation Critical: U.S. ERs Face Shortage of Doctors

Nov. 20, 2007 — -- In an emergency room situation the seconds between arriving, diagnosis and treatment can determine whether a patient lives or dies. But a study released today by the Center for Studying Health System Change suggests the nation's hospitals have a severe shortage of on-call specialists.

In fact, 21 percent of premature deaths and complications, which result from emergency room delays, are due to a lack of available specialists.

"It's becoming apparent that the specialist on-call issue for emergency rooms is becoming more and more of a problem," said Dr. Ann O'Malley of the Center for Studying Health System Change.

When Richard Nordmeyer suffered a stroke last year, there was no neurosurgeon in all of Arizona, New Mexico or Nevada who could answer the urgent calls to treat him.

"They told me in the emergency room that he would need immediate surgery, that he had a bleed on the brain," said his wife, Janice Nordmeyer. "They just kept saying they can send me somewhere else."

It took eight hours to find a qualified surgeon, who was located in San Francisco. It cost $45,000 to fly there, and the bill was charged to the couple.

And while he has recovered fully from the incident and the Nordmeyers' insurance footed the travel bill, his experience is not uncommon.

Part of the reason for shortage is that some doctors have found that providing care in an outpatient setting is simply more lucrative. Others worry about malpractice suits and payment by uninsured patients because hospital emergency rooms are required to treat patients regardless of their ability to pay.

Then, there is the crushing work schedule of an on-call physician, which has an effect of the quality of life.

"To come in the emergency department late at night … to leave your office practice has quality of life implications for the physician and the physician's family life," O'Malley said.

Hospitals believe they have found a cure for what ails their emergency rooms. They have added the on-call specialists to their regular payroll. Others offer them small stipends in return for their services.