STATE OF EMERGENCY (ROOMS)
Emergency Rooms are hiring fewer ER doctors due to a physician shortage and to cut costs, as outlined in the article from NPR: SHOTS, HEALTH NEWS FROM NPR
Article Summary:
Private equity firms are cutting costs in emergency rooms (ERs) by hiring fewer doctors and employing nurse practitioners and physician assistants who are paid less than half the salary of doctors, according to a confidential company document obtained by KHN and NPR. While it is unclear whether the staffing shift affected care, critics argue that reducing doctors and using less-trained staff increase the risk of misdiagnosis, inadequate care, and higher medical bills. A recent study of 44 emergency rooms across the Veterans Health Administration found that treatment by a nurse practitioner resulted in an average 7% increase in the cost of care and an 11% increase in the length of stay, extending patients' time in the ER by minutes for minor visits and hours for longer ones.
What to Expect in the Emergency Room; A Look at Different Service Providers:
In most cases, community emergency rooms are contracted through private agencies, driven by the goal of reducing costs and a shortage of medical doctors. Research facilities, on the other hand, do not contract with outside vendors for their ER services. Instead, medical students rotate through the ER as part of their ongoing training, providing exceptional expertise. However, because most research facilities also function as trauma centers, their emergency rooms tend to be busy, resulting in longer wait times.
Important Updates on Emergency Rooms: Shortages and Increased Wait Times
Hospital wait times have increased, but not all due to the flu or COVID-19. There needs to be more healthcare staff, including doctors and nurses. The American Association of Medical Colleges (AAMC) has projected a shortage of up to 121,900 physicians by 2032, with 21,400 and 55,200 physicians in primary care and between 33,700 and 86,700 in specialty care.
However, the shortage of healthcare staff is not the only issue. There's also a clog in the hospital discharge process due to a severe lack of step-down facilities, such as rehabilitation centers, for patients who are too sick to go home but too well to remain in the hospital. As a result, the length of hospital stays is increasing, and there are no simple answers to this problem.
We are triaged for urgency when we go to the ER with an illness. Emergency room wait times are now averaging four to six hours to be seen by a doctor, and often longer to get a bed in the ER. ER, long wait times are due to the "clog" in the hospital flow, with hospital beds occupied by planned surgeries, urgent surgeries, and admissions from the ER. With an increase in the length of stays due to decreased facilities for discharge, beds are emptying slower. As a result, ER wait times in lobbies have increased, and patients in ER beds requiring admission can wait for hours or even a day or two for a bed to open up. It's becoming common to board patients in the halls of an ER while waiting for a bed to become available.
The patient experience can reflect poorly on the hospital, and patients may be frustrated by the perceived disorganization. However, the shortage of healthcare staff is a significant problem, and hospitals are doing their best. With a shortage of ER doctors, Nurse Practitioners may begin to play an essential role in providing care.
KEEP ERs HEALTHY
As patients, we all have a responsibility to help keep our ERs healthy:
If you don’t have a primary care physician, get one! As part of your health team, they should be engaged enough to manage your health issues. When issues arise, allow them to guide you to the appropriate healthcare setting: office visit (assessment), urgent care center (after-hours or additional testing), or the ER (critical/urgent issues). This can help ER clogs and reduce wait times.
Don't put off contacting your PCP with any health concerns. Waiting too long can allow time for your condition to worsen.
If your PCP office takes more than 8 hours to address your calls or needs, consider finding a new practice that takes urgent patient calls seriously.
Be proactive with your health by following up with your doctors and taking recommended tests. Do your best to stay healthy and prevent illnesses.