American College of Emergency Physicians
October 11, 2022
Dr. Gabe Kelen is a professor and chair of emergency medicine at Johns Hopkins University in Baltimore, and a spokesman for the American College of Emergency Physicians. He and his colleagues published a major report on this issue last year in the New England Journal of Medicine Catalyst.
"These two papers really reinforce what we have been saying," Kelen said. "This is a huge issue that affects the vast majority of hospitals at least some of the time."
Long waits and overcrowding are more than just an inconvenience, said Kelen, who reviewed the new findings. They are also huge patient safety issues.
"When a hospital is greater than 85% full, you are asking for trouble and it's not unusual to be more than 100% occupied because the vast majority of hospitals need to keep beds full to make ends meet," he said.
Urgent care centers are popping up everywhere, but they aren't really picking up the slack because they are only options for people with insurance or disposable incomes, Kelen said.
"People who can't afford urgent care go to the emergency department," he said.
The solution includes staffing up, paying providers what they are worth, and improving access to and payment for telemedicine services, Kelen suggested.
Patience is part of the solution as well, he added.
"The level of experience in emergency departments is extraordinary, but we are not McDonald's," Kelen said. "You are seeing experts who are worth waiting for, but it may take a while and it's not fair to think you will be in and out in 10 minutes."
Some emergency rooms advertise their wait times so if you are not too sick, check online to see if you can time your arrival, he suggested.
This doesn't mean that you will get subpar care – especially in a true medical crisis.
"Anyone who is ultra-ultra-ill will be seen immediately, and there are things staff can get going from the waiting room," Kelen said.
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