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“…Waiting is the Hardest Part”

By Dr. Edward Wright

Prestige Emergency Room 

To borrow a line from one of many Tom Petty’s great songs: “The waiting is the hardest part.” The reality is simple: nobody enjoys waiting. “I wish they’d build another one of these here,” you might say two hours into your wait for a table at a local restaurant. Often—after languishing for that long—you are just as likely to walk out as you are to wait any longer.

Regardless, after that delay, you are even more in need of a meal than you were when you arrived.

Waiting in a crowded hospital ER is not that much different. But instead of simply being hungrier than you were before, an unexpectedly long wait in the ER could harm you or a loved one—or even lead to death. And that is no exaggeration.

Sadly, long waits in the ER do kill people—and it happens more often than you realize. The Internet is rife with jokes and memes about patients complaining in the ER about waiting to be seen by a doctor. It is not just a growing trend that you should wait in an ER for care, but that perhaps, you should even be thankful and appreciative that you are waiting, because that means others who already being seen are in even worse shape than you.

But make no mistake about it—ER overcrowding and long waits reflect worsened outcomes in every study that has been done. We don’t tolerate a wait when we’re paying for a $50 meal. Why on earth do we tolerate them when we’re paying thousands for our healthcare—or more to the point—our life or the life of a loved one might be on the line?

And considering that more than 40 percent of Americans will need the ER this year (be it for themselves or a family member), this is a challenge that is only going to fester as America’s population continues to grow (which will further tax access to emergency care).

In my career in hospitals, I have had more shifts than I care to count where patients have passed away while waiting for emergency care. In fact, earlier this month, I was relayed a story of a hospital with 12+ hour waits for care losing 4 waiting room patients in a single day.

Unfortunately, there are no mandatory reporting requirements for this and even if there were, they could be easily rationalized as being due to some other cause (other than a lack of prompt care).

Fellow patients in the waiting room sitting next to these unfortunate patients never know or see the final outcome so they are unlikely to report anything. Staff reporting is limited because of patient privacy issues. So the true extent of this problem is likely to be vastly underreported.

Does this mean that hospitals are dangerous? Absolutely not. What is dangerous, however, are the long wait times in hospital ERs. Texas hospitals—like countless others across the country—are plagued with staffing shortages, government regulations, and massive red tape that pulls them and their money in many different directions at once. They are unable to act quickly to correct longstanding system issues such as dangerously long wait times.

But even more than that, as health care money evaporates while population growth simultaneously explodes, the ability of existing facilities to shoulder this patient load is impossible. So they do the best they can with what they have. But patients are in desperate need of additional emergency care options.

The other obvious issue here is when you do finally make it out of the waiting room and into an evaluation room, you’ll find that you likely get to spend about two minutes with your doctor, while the doctor spends thirty more minutes reviewing your chart on his or her computer.

Your care is rushed and likely not going to be as thorough as it could otherwise be. Again, it all comes down to time. As waits add up, pressure is placed on medical staff to fix it by any means necessary. Unlike waiting room deaths, wait time metrics are tracked and reported regularly. So this is where the efforts are focused and the criticisms of staff are directed. In an interesting twist, providers are actually praised for how quickly they can move the highest number of patients in the fastest way possible.

As a result of dangerously high wait times and other factors, freestanding ERs came into existence. The freestanding ER is the only emergency care innovation put into place that has provided a realistic way to address the life-or-death issue of wait times.

While hospitals have been working for many years to find solutions to this challenge, they have been unable to make any substantive changes. There are just too many outside forces to confront. So even hospital leaders have realized that an ancillary effect of the Freestanding ER model—which has given patients a quicker avenue to emergency care—is that it provides a highly effective method of decreasing waits at their own hospital facilities.

This is evidenced by the rapid rate of growth we’re seeing in hospital systems building their own freestanding ERs in different communities across Texas. The freestanding ER model is a life-saving model of emergency care—and it is working to save the lives of Texans every day. More support for this model will go a long way towards getting many more Texans out of harm’s way.

Waiting really is the hardest part—especially when you need emergency care. Patients deserve to be seen and treated as quickly as possible. The data illustrates that when this happens, lives are saved.

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