In the past years, ED visits have increased and the number of EDs has decreased. The inevitable consequence is more patients in fewer EDs and longer waits to be seen.
A recent study published in Health Affairs by doctors at Harvard Medical School documents this for patients with acute myocardial infarction (AMI) and those requiring immediate attention. The median wait time to be seen by an ED physician in 2004 for a patient with AMI was 20 minutes and the median wait time for patients with an “emergent” condition was 14 minutes . The median wait time for all adults was 30 minutes. All these numbers are up from 1997. No big surprise here.
The surprising thing to me is why are the wait time so short? As a 30 year veteran of the ED I can attest that patients with AMIs and “emergent” conditions comprise few of the patients who use the emergency department. Not only is the ED the safety net for those with no medical home, it also serves those who have a private doctor but are unable to be seen urgently, and those who come just for the convenience of not having to make an appointment. Patients have also learned that the ED provides “one stop shopping”. They can get all their studies done while in the ED and do not have to schedule follow up appointments for x rays, lab work, stress tests, etc. In additions most EDs have to cope with “boarding ” patients who are waiting for a room due to inpatient bed shortages.
In my opinion, we should not be trying to divert patients out of the ED but expand ED resources and staff. We see patients 24 hours a day 7 days a week and we do a good job.