What makes it take so long to be seen in the ER?

[jdoggg12]

I've been in the ER numerous times for various reasons and it has NEVER been a speedy process. All of the hospitals weren't busy (ER area at least), yet it still took an inorinate amount of time.

What is the deal? Does anyone have any insight as to why it is so slow? You wait for 30-300minutes in the waiting room, fill out some papers, wait for another 30-300 minutes on the table, the Dr looks at you/fixes you, you wait another 30-300minutes for a nurse to give you a couple pills and a paper telling you how to take them.

Really though? What takes so long?

Also, if they're going to charge top dollar ($2k+ is easy for an ER visit) why cant they put some urgency on it?

This is all from first hand experience where you can see its not that busy and regardless of whether you're in really bad shape or just got a bit of food poisoning.

 

[Manuwell]

Making it easier/faster could lead people to go there for simple flu or headache.

Keeping it slow allow them to get rid of minor and annoying cases.

 

[newnameman]

Illegal immigrants

 

[txrandom]

Originally posted by: newnameman
Illegal immigrants

QTF When I went to get my appendix out, I saw tons of illegals!

 

[jdoggg12]

Originally posted by: Manuwell
Making it easier/faster could lead people to go there for simple flu or headache.

Keeping it slow allow them to get rid of minor and annoying cases.

Triage... besides, going there for a flu/headache would be fix in short oder once the ER bills started rolling in.

 

[waggy]

Originally posted by: newnameman
Illegal immigrants

not just Illegals (though that is a huge reason). last time i was in a lady brought in her infant to get its immunization shots and to get some formula for the baby. After the nurses raised hell for wasting there time they threw her out. They do not do immunizations or give out formula but sh thought they would.

Another time when my my stitches from my appendix came loose (that was nasty). while waiting to get in we got to talking to 2 people who came in. one came in because the child had a cold. the other was for something just ad idiotic.

i asked why they didn't go to a clinic. They wouldn't go because the clinic wouldn't let them go and they couldn't afford to go

 

[biggestmuff]

poor people

/thread

 

[Manuwell]

Originally posted by: jdoggg12

Originally posted by: Manuwell
Making it easier/faster could lead people to go there for simple flu or headache.

Keeping it slow allow them to get rid of minor and annoying cases.

Triage... besides, going there for a flu/headache would be fix in short oder once the ER bills started rolling in.

IMO it (big bills) wouldn't hurt some people doing good with the money. The very same people who wouldn't wait until the next appointment to their physician. At some point, keeping the ER slow/unconvenient makes it available to everyone who needs it and doesn't not turn it into a I-don't-care-what-it-cost-fast-physician-office.

 

[Cabages]

OMG, havent you seen all the hospital shows like ER and the like? Its obvious they're just having sex in the back.

 

[Eos]

I went in with shortness of breath and I never sat down to fill anything out until after I was fixed.

Allergic reaction ftw!

 

[cardiac]

I work full time as a firefighter/paramedic, but moonlight in our local ER about 24 hours a week. A lot of answers above are true. We don't have a lot of room, (14 beds), and see an average of 100 patients in 24 hours. Averages out to 35,000 or so a year.

Now, there are 14 rooms and 4 nurses. They have to take care of at least 3 rooms each. This could be a heart attack, a runny nose, and a psycho all at once. That's one nurse..... But, if someone comes in and we have a bed, we do not make any one wait. Here in NW Indiana, the average time in and out for oh, say an ankle sprain, is under 2 hours. Exam, X-rays, post-mold (Splint) or soft cast, some vicoden for the pain, and you are out the door in a couple of hours. Have a bad stroke, and you might be here for a while (Unless we ship you off to surgery).

That's not to say there aren't bad nights when we are standing room only, a BS case might wait an hour or 2 just to be seen. Very sick people get to go first

Bob

 

[marvdmartian]

Yeah, OP, without knowing why you went into the ER, it's impossible for someone to give a logical reason why you waited so long. Add to that the ridiculous reasons some people go into hospital ER's, the folks that go in because they don't have their own doctor/insurance/money to pay (and know that the hospital has to see them, irregardless of their ability to pay), etc, etc, ad nauseum, and you might get some idea of why.
Your waiting time is based pretty much on triage. True emergencies (brought in usually by ambulance) will go first, followed by people with lesser emergencies, going down the line to the morons that are just there for stupid reasons. The last time I went into the ER, it's because I (unsuccessfully) tried to remove my fingertip with a conveyor chain. I was a walk-in, and took my number, and waited for the triage nurse to call my number. Once he saw what I'd done (and turned a most curious shade of green), I was seen pretty quickly. Still, with waiting for x-rays, cleaning the wound, etc, etc, it was close to 3 hours before I left there, with 5 stitches and an admonishment to keep it clean.

 

[DrPizza]

When you go to the Emergency room with an emergency, you're seen immediately. Heart attack? There is no wait. Anaphylactic shock? There is no wait. Life-threatening bleeding? Nope, no wait for that either.


Runny nose? "Hey, Mary, I know you're busy with the guy with the heart attack. But, do you want to squeeze in the guy with the runny nose?" "No, he can wait."

"GAhhhhh! But, but, but, but my runny nose might be from bird flu!! I saw it on CNN! This could be fatal!!!! Help me!"

 

[jdoggg12]

Originally posted by: marvdmartian
Yeah, OP, without knowing why you went into the ER, it's impossible for someone to give a logical reason why you waited so long. Add to that the ridiculous reasons some people go into hospital ER's, the folks that go in because they don't have their own doctor/insurance/money to pay (and know that the hospital has to see them, irregardless of their ability to pay), etc, etc, ad nauseum, and you might get some idea of why.
Your waiting time is based pretty much on triage. True emergencies (brought in usually by ambulance) will go first, followed by people with lesser emergencies, going down the line to the morons that are just there for stupid reasons. The last time I went into the ER, it's because I (unsuccessfully) tried to remove my fingertip with a conveyor chain. I was a walk-in, and took my number, and waited for the triage nurse to call my number. Once he saw what I'd done (and turned a most curious shade of green), I was seen pretty quickly. Still, with waiting for x-rays, cleaning the wound, etc, etc, it was close to 3 hours before I left there, with 5 stitches and an admonishment to keep it clean.

I was in the ER for various reasons:

Food poisoning with SEVERE dehydration
2 sprained, possible fractured ankles (motorcycle crash)
3" gash in my scalp to the bone bleeding badly (fight with roommate)
dislocated shoulder
Alcohol poisoning

All of these had a 30+ min wait and none of them had more than 3 other people waiting in the waiting room and averaged 1 ambulance entrance per visit

 

[cKGunslinger]

I've never spent less than ~6 hours in an ER. Never less than 1.5 hours before even being seen by a nurse.

Child's broken arm
Child's 104+ fever
etc

 

[Balt]

Because many of the people who go to the "Emergency" Room go there for frivolous, non-emergency reasons. Probably because they either feel entitled and can't be bothered to make an appointment with a regular physician for their head cold or because they don't have insurance. Also there are people who go in trying to convince someone they need pain medication so they can get a fix.

 

[Suspicious-Teach8788]

Originally posted by: DrPizza
When you go to the Emergency room with an emergency, you're seen immediately. Heart attack? There is no wait. Anaphylactic shock? There is no wait. Life-threatening bleeding? Nope, no wait for that either.


Runny nose? "Hey, Mary, I know you're busy with the guy with the heart attack. But, do you want to squeeze in the guy with the runny nose?" "No, he can wait."

"GAhhhhh! But, but, but, but my runny nose might be from bird flu!! I saw it on CNN! This could be fatal!!!! Help me!"

What kind of emergency? GSW? Sure. My neighbor has severe asthma and sometimes the attacks just come. His mom's a nurse but what else can they do? They still have to go to the ER. It still takes an hour at the very minimum. Yea he gets it shaved down from 2.5 hours, but having an asthma attack for an hour straight is not very fun either.

 

[spidey07]

Originally posted by: DrPizza
When you go to the Emergency room with an emergency, you're seen immediately. Heart attack? There is no wait. Anaphylactic shock? There is no wait. Life-threatening bleeding? Nope, no wait for that either.


Runny nose? "Hey, Mary, I know you're busy with the guy with the heart attack. But, do you want to squeeze in the guy with the runny nose?" "No, he can wait."

"GAhhhhh! But, but, but, but my runny nose might be from bird flu!! I saw it on CNN! This could be fatal!!!! Help me!"

You stop with your common sense.

Seriously though. This is the reason.

 

[spidey07]

Originally posted by: jdoggg12

Originally posted by: marvdmartian
Yeah, OP, without knowing why you went into the ER, it's impossible for someone to give a logical reason why you waited so long. Add to that the ridiculous reasons some people go into hospital ER's, the folks that go in because they don't have their own doctor/insurance/money to pay (and know that the hospital has to see them, irregardless of their ability to pay), etc, etc, ad nauseum, and you might get some idea of why.
Your waiting time is based pretty much on triage. True emergencies (brought in usually by ambulance) will go first, followed by people with lesser emergencies, going down the line to the morons that are just there for stupid reasons. The last time I went into the ER, it's because I (unsuccessfully) tried to remove my fingertip with a conveyor chain. I was a walk-in, and took my number, and waited for the triage nurse to call my number. Once he saw what I'd done (and turned a most curious shade of green), I was seen pretty quickly. Still, with waiting for x-rays, cleaning the wound, etc, etc, it was close to 3 hours before I left there, with 5 stitches and an admonishment to keep it clean.

I was in the ER for various reasons:

Food poisoning with SEVERE dehydration
2 sprained, possible fractured ankles (motorcycle crash)
3" gash in my scalp to the bone bleeding badly (fight with roommate)
dislocated shoulder
Alcohol poisoning

All of these had a 30+ min wait and none of them had more than 3 other people waiting in the waiting room and averaged 1 ambulance entrance per visit

NOT AN EMERGENCY.

 

[jdoggg12]

Originally posted by: spidey07

Originally posted by: jdoggg12

Originally posted by: marvdmartian
Yeah, OP, without knowing why you went into the ER, it's impossible for someone to give a logical reason why you waited so long. Add to that the ridiculous reasons some people go into hospital ER's, the folks that go in because they don't have their own doctor/insurance/money to pay (and know that the hospital has to see them, irregardless of their ability to pay), etc, etc, ad nauseum, and you might get some idea of why.
Your waiting time is based pretty much on triage. True emergencies (brought in usually by ambulance) will go first, followed by people with lesser emergencies, going down the line to the morons that are just there for stupid reasons. The last time I went into the ER, it's because I (unsuccessfully) tried to remove my fingertip with a conveyor chain. I was a walk-in, and took my number, and waited for the triage nurse to call my number. Once he saw what I'd done (and turned a most curious shade of green), I was seen pretty quickly. Still, with waiting for x-rays, cleaning the wound, etc, etc, it was close to 3 hours before I left there, with 5 stitches and an admonishment to keep it clean.

I was in the ER for various reasons:

Food poisoning with SEVERE dehydration
2 sprained, possible fractured ankles (motorcycle crash)
3" gash in my scalp to the bone bleeding badly (fight with roommate)
dislocated shoulder
Alcohol poisoning

All of these had a 30+ min wait and none of them had more than 3 other people waiting in the waiting room and averaged 1 ambulance entrance per visit

NOT AN EMERGENCY.

What exactly is your definition of emergency?

 

[The Sauce]

I am an ER doctor so I think I can answer your question:

1.) Most private physicians are being driven out of practice by low reimbursement and high malpractice. Hence people are being forced to go to the ER for primary care complaints which would previously have been treated by a family doctor.

2.) The majority of people who utilize the ER are self-pay (i.e. no-pay), welfare or medicaid and the ER gets reimbursed virtually nothing for seeing them. Hence ER staffing is poor and volume is high with low acuity, BS cases.

3.) The ER is geared for critical care and trauma, but is overutilized for nonsense like ankle sprains, tooth aches, colds, stubbed toes, back pain, and psychiatric problems. The ER is unable to turn away these people because the government mandates that the ER must see everyone regardless of the problem or ability to pay. Hence, you may be waiting while someone with toe pain is being seen for the 3rd time that day for the same problem.

4.) If you had to wait that long you probably weren't really sick and/or there were sicker people that had to be seen first (i.e. triage process). If you are there with a dislocated shoulder, there is one ER doctor on, and he is dealing with a heart attack patient...you wait. Also most people who come to the ER do not have serious medical illness, but think that they do because of their anxiety and irrational fear over it.

5.) Hospitals are in general overcrowded. This means that the ER is being used as a boarding facility for admitted patients - sometimes for several days. Thus even though the waiting room may not look busy, the ED may be full taking care of patients that should be in a bed in the hospital.


Your post assumes that the ER is profitable because they charge a lot of money and, thus, they should improve service to see more people and make more money. That thought is flawed. The ER generally does not make money - generally they lose money and depend heavily on government subsidies which are continually dwindling. They charge a lot to the people who can pay (i.e. the insured) in order to cost-shift because 80% of the people they see won't, don't or can't pay. The ER is not a business with profit motive - it is a hospital service that is mandated by the government, heavily regulated by the government and largely funded by...you guessed it, the government. ER doctors are at extremely high legal risk, get sued frequently (roughly once every 2 years on average), and so are hard to find, burn out quickly, and tend to have short careers. This has lead to nationwide staffing shortages and your treatment delays.

Hope that answers your question.


PS - just to settle the ongoing debate:

motorcycle accident - emergency
fight with roommate with head gash - stupid but also a reasonable emergency
food poisoning (if really dehydrated, which is rare) - reasonable
drunk - not an emergency
dislocated shoulder - definitely an emergency

 

[spidey07]

Originally posted by: jdoggg12
What exactly is your definition of emergency?

Something that can significantly affect life or death and depends on swiftness of action.

Food poisening/dehydration - not a big deal, stick an IV in you and give you fluids. If you aren't passed out, you're not that dehydrated

Sprained/fractured ankles? Unless your tiberal artery is hanging out of your ankle....not life threatening.

3" gash in the head? Minor blood loss, some stiches, you're fine. You didn't hit a major artery if it's on your skull.

Dislocated shoulder? WTF??? That's an emergency?

Alchohol poisoning - well that can be an emergency but the ER knows how to tell the difference between somebody that is completely out of it an poisoning. This is the only thing listed that would classify as an emergency.

 

[worthless085]

Emergencies = Significant problems with Airway, Breathing, or Circulation. Anything else will not kill you while waiting a few hours.

 

[jdoggg12]

Originally posted by: Snatchface
I am an ER doctor so I think I can answer your question:

1.) Most private physicians are being driven out of practice by low reimbursement and high malpractice. Hence people are being forced to go to the ER for primary care complaints which would previously have been treated by a family doctor.

2.) The majority of people who utilize the ER are self-pay (i.e. no-pay), welfare or medicaid and the ER gets reimbursed virtually nothing for seeing them. Hence ER staffing is poor and volume is high with low acuity, BS cases.

3.) The ER is geared for critical care and trauma, but is overutilized for nonsense like ankle sprains, tooth aches, colds, stubbed toes, back pain, and psychiatric problems. The ER is unable to turn away these people because the government mandates that the ER must see everyone regardless of the problem or ability to pay. Hence, you may be waiting while someone with toe pain is being seen for the 3rd time that day for the same problem.

4.) If you had to wait that long you probably weren't really sick and/or there were sicker people that had to be seen first (i.e. triage process). If you are there with a dislocated shoulder, there is one ER doctor on, and he is dealing with a heart attack patient...you wait. Also most people who come to the ER do not have serious medical illness, but think that they do because of their anxiety and irrational fear over it.

5.) Hospitals are in general overcrowded. This means that the ER is being used as a boarding facility for admitted patients - sometimes for several days. Thus even though the waiting room may not look busy, the ED may be full taking care of patients that should be in a bed in the hospital.


Your post assumes that the ER is profitable because they charge a lot of money and, thus, they should improve service to see more people and make more money. That thought is flawed. The ER generally does not make money - generally they lose money and depend heavily on government subsidies which are continually dwindling. They charge a lot to the people who can pay (i.e. the insured) in order to cost-shift because 80% of the people they see won't, don't or can't pay. The ER is not a business with profit motive - it is a hospital service that is mandated by the government, heavily regulated by the government and largely funded by...you guessed it, the government. ER doctors are at extremely high legal risk, get sued frequently (roughly once every 2 years on average), and so are hard to find, burn out quickly, and tend to have short careers. This has lead to nationwide staffing shortages and your treatment delays.

Hope that answers your question.

Thank you for your answer... i had no idea it was so grim for hospitals. I've never not paid a bill, i just cant see how the hospital would let people not pay. I got collections notices (b/c of the hospitals poor billing practices not my lack of payment) and they wouldve gone on my credit. I simply cant believe that 80% of hospital patients would allow a collections notice to go on their credit... that just amazes me.

All of my visits were ER worthy, i would never think of clogging the ER for something trivial. Though they may not be life threatening, they weren't something i could let sit, waiting for primary care, either (aside from the shoulder i guess)

-Food poisoning was pretty major since i couldn't get any liquids in my body for over 12 hrs, i was in severe cold sweats, shivering and having trouble remaining upright. I had 3 bags of saline given and a ton of antibiotics.

-The ankles were pretty major and ended up both being severely sprained, i couldn't walk in and the ambulance on the race track wanted to take me in b/c they thought they were both broken b/c of the swelling and speed of the crash. (Motorcycle crash - another rider slid in to me and his bike landed on my boots)

-3" Gash in the head - it wouldn't stop bleeding, even an hour after the incident (11pm). Though not life threatening, i'd say any gash that can soak a sweatshirt twice-over in blood is worthy of needing ER care

-Dislocated shoulder... yes, least of the injuries in terms of direness, i was alone when it happened (mountain biking) and didn't know if something was broken. Again, not something a primary care is going to handle at 8pm

-Alcohol poisoning - At a party i was doing beer bong hits and someone spiked my 2nd one with 6+ shots of rumpleminz. I blacked out 20 min later and was taken to the ER. I dont remeber exactly how long i was there but my gf was getting really pissed the guy with a broken finger that got there at the same time got in before us.


I'm just frustrated when i hear about other people that have serious shit happening and people with lame problems in the waiting room with them get in first (as was the case in all of mine). It further angers me that we pay so much more b/c of the losers who dont pay.

 

[cKGunslinger]

Originally posted by: spidey07

Originally posted by: jdoggg12
What exactly is your definition of emergency?

Something that can significantly affect life or death and depends on swiftness of action.

Food poisening/dehydration - not a big deal, stick an IV in you and give you fluids. If you aren't passed out, you're not that dehydrated

Sprained/fractured ankles? Unless your tiberal artery is hanging out of your ankle....not life threatening.

3" gash in the head? Minor blood loss, some stiches, you're fine. You didn't hit a major artery if it's on your skull.

Dislocated shoulder? WTF??? That's an emergency?

Alchohol poisoning - well that can be an emergency but the ER knows how to tell the difference between somebody that is completely out of it an poisoning. This is the only thing listed that would classify as an emergency.

So you're saying that any of these happen to you on a Friday evening, just buck-up and wait to make an appointment with your GHP on Monday morning, and see if he can squeeze you in sometime during the week? :roll: