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 headed “No time for waiting?  Our Emergency Room wait times are now available online – and on your phone.”

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.

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