ER Wait Time Problems Widespread

John H. Stroger Jr. Hospital of Cook County in Chicago bears little resemblance to County General Hospital -- its fictional counterpart in the television series "ER."

Instead, a waiting patient may be reminded of the show "24," because patients can sometimes wait a full day to receive treatment, according to attending physician Dr. Robert Saqueton.

"Real emergencies are lost in the shuffle," Saqueton said.

Furthermore, he added, doctors need to see too many patients to have the type of relationship that the fictional doctors have with patients on "ER."

This problem and its consequences, which many hospitals face, were brought home to many when Edith Rodriguez died waiting to be treated on the floor of Los Angeles' Martin Luther King Jr. Harbor Hospital last month.

But while critics have pointed to poor fiscal responsibility in the case of Stroger, or poor patient care in the case of King Harbor, a look at emergency rooms around the nation shows that wait times -- and their health consequences -- are increasing everywhere.

The problem isn't confined to hospitals that serve mostly the uninsured. Wait times of several hours also occur at places like Hoag Hospital in Orange County, Calif., according to Carla Schneider, a registered nurse and director of the emergency care unit there.

"It does get frustrating," she said. "People deserve better care."

On Friday, June 22, nearly a year after the Institute of Medicine issued three reports chronicling a rise in numbers of emergency patients and a decline in the number of emergency facilities nationwide, the House Committee on Oversight and Government Reform listened to testimony from five physicians in a hearing titled "The Government's Response to the Nation's Emergency Room Crisis."

"It's clearly a national problem," said Dr. Ramon Johnson, a member of the board of directors of the American College of Emergency Physicians (ACEP), who was among the doctors who testified.

Johnson, who lives in a wealthier part of Southern California, said his area still lacks hospital beds.

"Even in the affluent communities, if they haven't built any new hospitals, we're seeing the same problems they're seeing in the urban areas," he said.

While many people may be aware of emergency department wait times, they don't know the potential harm, Johnson said.

Other emergency physicians share his apprehension.

"The real concern is you sit out in the waiting room with some vague back ache, and you could be sitting on a heart attack or a leaking aneurysm," said Dr. Peter Viccellio, clinical director of the emergency department at SUNY Stonybrook.

While emergency physicians disagree about some of the specific causes of ER overcrowding, among the leading culprits many point to is a practice known as "boarding."

Boarding occurs when a patient who has been treated in the ER is kept there afterward because of a lack of available inpatient beds elsewhere in the hospital. The ER can fill up with patients, resulting in what Viccellio describes as "a phone booth."

In a poll of emergency physicians in New York, New Jersey and Connecticut conducted by ACEP this past February, just under 65 percent of physicians said they had personal experience with a patient being harmed by boarding -- and 23 percent said they had personal experience with a patient dying because of it.

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