This is probably the dumbest question ever - but what will it take for hospital administration to hire more people to care for the growing needs that you list in the article? Maybe you should interview them on one of your podcasts - if they would agree to be interviewed.
Tangential to Seneca Plutarchus (and to your post): Shortly pre-pandemic, my wife fell on the ice and broke her wrist. After almost three hours in the ER waiting room, with a friend advocating for her (I was out of town) but still not having been either seen or even interviewed, she thought to call her primary practice for advice. They had no facilities to treat her, but told her that the hospital in whose ER she was waiting also has a walk-in clinic at their orthopedic facility a couple of miles away. Her friend immediately drove her there (so she became a "left before treatment" statistic), where she was seen within minutes and treated quickly. The break was set by the (50-something) PA who is in charge of the clinic, but with the supervision and approval of the orthopedic surgeon (30-something), who said the PA had done hundreds of them (20 years as an army medic), many more than she had. The bones were so well set that in the end no surgery was required. - But the point is that the ER could not even inform my wife of the existence of an alternative. Several physicians have since told us that an ER cannot do anything that might seem to be sending a patient to a facility with a lower level of care - even if that facility is part of the same hospital. (At the time the hospital was affiliated with MGB; it's now a fully integrated part of the MGB system, with the old hospital name replaced by MGB signs everywhere.) - This is clearly a fairly uncommon scenario, but it highlights some limitations of the system. Thanks for your thoughts.
"In fact, I think what’s happening is that because we focus on the sickest patients first—of whom there are somewhat more than in the past, owing to these issues and the aging population generally—it’s the somewhat less acutely ill patients who are affected by longer waits and visits."
Triage works as a form of rationing. If the patient doesn't want to wait to be seen, they probably weren't that sick, right?
I’ve spent the last four years in and out of the hospital. The only year I remember the wait time to be seen being so bad was last month. I think I was waiting three hours to be seen. Once they decided to admit me, the wait was another three hours. A few years ago, I was in the ER and the wait time was to get a room on a floor was 12 hours! This is in Santa Barbara, CA. Last Summer I had scheduled surgery at UCLA Medical Center. After getting out of recovery, they had me in one of those rooms that’s meant for folks only staying a day or two. I was in that unit for all six days of my stay cause all the rooms with single beds were full.
Spring 2022 My daughter and I drove my husband to ER at Mass General in Boston for a fairly serious issue that we knew our local regional hospital couldn’t deal with in the pandemic. We were triaged right away, EKG very fast, IV fast, nurses and doctors thorough with testing. We were able to solve the immediate health issue, drive him back home within 12 hours. So grateful the staff was very kind despite being extremely busy and they held him long enough for nursing observation. We believe the correct expert diagnosis and rapid treatment avoided an unnecessary local hospitalization during the pandemic.
This is probably the dumbest question ever - but what will it take for hospital administration to hire more people to care for the growing needs that you list in the article? Maybe you should interview them on one of your podcasts - if they would agree to be interviewed.
Tangential to Seneca Plutarchus (and to your post): Shortly pre-pandemic, my wife fell on the ice and broke her wrist. After almost three hours in the ER waiting room, with a friend advocating for her (I was out of town) but still not having been either seen or even interviewed, she thought to call her primary practice for advice. They had no facilities to treat her, but told her that the hospital in whose ER she was waiting also has a walk-in clinic at their orthopedic facility a couple of miles away. Her friend immediately drove her there (so she became a "left before treatment" statistic), where she was seen within minutes and treated quickly. The break was set by the (50-something) PA who is in charge of the clinic, but with the supervision and approval of the orthopedic surgeon (30-something), who said the PA had done hundreds of them (20 years as an army medic), many more than she had. The bones were so well set that in the end no surgery was required. - But the point is that the ER could not even inform my wife of the existence of an alternative. Several physicians have since told us that an ER cannot do anything that might seem to be sending a patient to a facility with a lower level of care - even if that facility is part of the same hospital. (At the time the hospital was affiliated with MGB; it's now a fully integrated part of the MGB system, with the old hospital name replaced by MGB signs everywhere.) - This is clearly a fairly uncommon scenario, but it highlights some limitations of the system. Thanks for your thoughts.
Dr. Faust, Your’s is a very informative analysis. Thanks.
"In fact, I think what’s happening is that because we focus on the sickest patients first—of whom there are somewhat more than in the past, owing to these issues and the aging population generally—it’s the somewhat less acutely ill patients who are affected by longer waits and visits."
Triage works as a form of rationing. If the patient doesn't want to wait to be seen, they probably weren't that sick, right?
I’ve spent the last four years in and out of the hospital. The only year I remember the wait time to be seen being so bad was last month. I think I was waiting three hours to be seen. Once they decided to admit me, the wait was another three hours. A few years ago, I was in the ER and the wait time was to get a room on a floor was 12 hours! This is in Santa Barbara, CA. Last Summer I had scheduled surgery at UCLA Medical Center. After getting out of recovery, they had me in one of those rooms that’s meant for folks only staying a day or two. I was in that unit for all six days of my stay cause all the rooms with single beds were full.
Spring 2022 My daughter and I drove my husband to ER at Mass General in Boston for a fairly serious issue that we knew our local regional hospital couldn’t deal with in the pandemic. We were triaged right away, EKG very fast, IV fast, nurses and doctors thorough with testing. We were able to solve the immediate health issue, drive him back home within 12 hours. So grateful the staff was very kind despite being extremely busy and they held him long enough for nursing observation. We believe the correct expert diagnosis and rapid treatment avoided an unnecessary local hospitalization during the pandemic.