Wednesday, November 30, 2011
At Last!!!
Early in my career, I observed that if any other form of
organization had a service as popular as the hospital emergency room, it would
be promoting it vigorously instead of fighting it, as hospitals were doing then
and continued to do for years thereafter.
Now I note that the Boston Globe Magazine of Sunday,
November 27 carries an ad by suburban Newton-Wellesley Hospital
A common complaint about emergency rooms is their hours-long
waiting times. The Newton-Wellesley ad
was not so bold as to urge one to use the service, but the clear implication
was that if you needed to do so, or were so inclined, you would find the waiting time
acceptable. The sample shown in the ad
was 34 minutes.
The reluctance of hospitals to promote their emergency room
services most likely arises out of the influence of the private medical
practitioners on their staffs who have seen those services as competition –
attracting paying patients who, in their view, ought to be seen in their
private offices. This concern has given
rise to the unsubstantiated claim that providing episodic care in the emergency
room leads to lower quality by interfering with continuity. An even more prevalent myth is that emergency
care is more costly than that provided in doctors’ offices – an assertion that
ignores the fixed cost associated with the 24/7 nature of emergency room
operation. Since the doctors and nurses
have to be there around the clock anyway, the non-emergency cases allow the
cost of such coverage to be spread over a larger number of patients, thus reducing the
cost per case.
Perhaps we are in the process of getting beyond all
that. At least the Newton-Wellesley ad
would make it seem so.
