So the CDC says avg ER wait is around 56 minutes...

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keeping-it-real

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In 10 years we've gone from 38 minutes to 56 minutes. I think some awards are in order.

http://news.yahoo.com/s/ap/20080806/ap_on_he_me/med_er_waiting;_ylt=AvrRl6ygIU9Klwv.JhDjsLrVJRIF

"ATLANTA - The average time that hospital emergency rooms patients wait to see a doctor has grown from about 38 minutes to almost an hour over the past decade, according to new federal statistics released Wednesday.

The increase is due to supply and demand, said Dr. Stephen Pitts, the lead author of the report by the Centers for Disease Control and Prevention.

"There are more people arriving at the ERs. And there are fewer ERs," said Pitts, an associate professor of emergency medicine at Atlanta's Emory University.

Overall, about 119 million visits were made to U.S. emergency rooms in 2006, up from 90 million in 1996 — a 32 percent increase.

Meanwhile, the number of hospital emergency departments dropped to fewer than 4,600, from nearly 4,900, according to American Hospital Association statistics.

Another reason for crowding is patients who are admitted to the hospital end up waiting in the ER because of the limited number of hospital beds, Pitts added.

A shortage of surgical specialists also contributes. So, too, does the difficulty many patients have in getting appointment to doctor's offices — which causes some to turn to emergency departments, experts said.

"It takes me a month to get an appointment for my own doctor, and I'm a physician, for God's sake," said Dr. Ricardo Martinez, an Atlanta emergency physician. He is executive vice president of Schumacher Group, an organization that manages about 140 hospital emergency departments.

The amount of time a patient waited before seeing a physician in an ER has been rising steadily, from 38 minutes in 1997, to 47 minutes in 2004, to 56 minutes in 2006.

Pitts added that 56 minutes may be the average, but it's not typical: The average was skewed to nearly an hour because of some very long waits.

"Half of people had waiting times of 31 minutes or less," Pitts noted.

Researchers also found that there has not been any recent increases in the number of patients arriving by ambulance, or in the number of cases considered to be true emergencies.

Black patients visited emergency departments at twice the rate as whites in 2006. Among age groups, the highest visitation rates were for infants and elderly people aged 75 and older.

About 40 percent of ER patients had private insurance, about 25 percent were covered by state programs for children and about 17 percent were covered by Medicare, the report found. About 17 percent were uninsured.

Some more findings: Summer and winter were the busiest season in ERs, and the early evening — around 7 p.m. — tended to be the busiest time of day. There were geographic differences as well, with hospitals in the South having the highest ER visitation rates.

Also, half of hospital admissions in 2006 came through emergency departments, up from 36 percent in 1996.

"The ER has become the front door to the hospital," said Pitts, a fellow at the CDC's National Center for Health Statistics.

Some doctors said the report supports a call for increased governmental funding for hospital emergency services.

"Millions more people each year are seeking emergency care, but emergency departments are continuing to close, often because so much care goes uncompensated," Dr. Linda Lawrence, president of the American College of Emergency Physicians, said in a statement.

"This report is very troubling, because it shows that care is being delayed for everyone, including people in pain and with heart attacks," her statement added.

The results are based on a national survey of 362 hospital emergency departments."
 
I just spoke with one of my friends who runs a large university internal medicine clinic. Their average wait for SCHEDULED appointiments is 36 minutes.

Considering what we are up against - 56 minutes is pretty impressive!
 
The skew is screwing up the picture. During my average day shift I see them as they come until the beds are full. This can be 15 or more depending on acuity level and support. Sometime around midday, the journey to Mecca starts and the line in triage backs up. Invariably we are sitting on a couple of rule outs and uroseptic lols. Then....crash! The waits balloon in proportion to severity of illness waiting. I can go thru the meat of an evening shift and barely see more people than can Dr. LWOBs who is a friend to all. Then on overnight after we have found beds, transferred patients and can actually breathe for a minute, you can slog through what's left and what is coming in pretty rapidly. Many times from the hours of 3am to 10am., bed to doctor time is instantaneous. And then the 3-6 hour wait kicks in again and the frustration begins. So where I work, your mean would be skewed with some long waits and instantaneous appearances. I can buy that this would avg out to an hour. In practice, remember there are a lot of double digit waits pulling it out even worse.

This may not even make since. I'm tripping my ambien:zip: a little quicker than usual and am a little wobbly, To bed I go after a long and probably pointless drug infused post-pad!+pad+
 
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I just spoke with one of my friends who runs a large university internal medicine clinic. Their average wait for SCHEDULED appointiments is 36 minutes.

Considering what we are up against - 56 minutes is pretty impressive!
I was being serious. Medals. They are in order. Only an 18 minute increase over the last decade is pretty impressive.

The skew is screwing up the picture. During my average day shift I see them as they come until the beds are full. This can be 15 or more depending on acuity level and support. Sometime around midday, the journey to Mecca starts ans the line in triage back up. Invariably we are sitting on a couple of rule outs and uroseptic lols. Then....crash! The waits balloon in perportion to severity of illness waiting. I can go thru the meat of an evening shift and barely see more people than can Dr. LWOBs friend to all. Then on overnight after we have found beds, transferred patients and actually breathe a minute, you can slog through what's left and what is coming in pretty rapidly. Many times from the hours of 3am to 10am., bed to doctor time is instantaneous. And then the3-6 hour wait kicks in again and the frustration begins. So where I work, your mean would be skewed with some long waits and instantaneous appearances. I can buy that this would avg out to an hour. In practice, remeber there are a lot of double digit waits pulling it out even worse.

This may not even make since. I'm tripping my ambien:zip: a little quicker than usual and am a little wobbly, To bed I go after a long and probably pointless drug infused post-pad!+pad+
Oh it makes since alright...
 
The average wait isn't accurate. Our FastTrack patients are usually seen and dispo'd within an hour -- the average wait to be seen only about 15 minutes. Some of the more serious patients that need cardiac monitoring and so forth may wait 2-3 hours before they get a bed. One wonders why we make more sick patients wait to move the less acute quickly, but the FastTrack area is not equipped (monitoring and staffing wise) to handle such higher acuity patients.
 
less than an hour... those are pretty nice numbers
 
The average wait isn't accurate. Our FastTrack patients are usually seen and dispo'd within an hour -- the average wait to be seen only about 15 minutes. Some of the more serious patients that need cardiac monitoring and so forth may wait 2-3 hours before they get a bed. One wonders why we make more sick patients wait to move the less acute quickly, but the FastTrack area is not equipped (monitoring and staffing wise) to handle such higher acuity patients.

A patient who needs a cardiac monitor may wait 2-3 hours to get that monitor after initial presentation? Are you serious?
 
A patient who needs a cardiac monitor may wait 2-3 hours to get that monitor after initial presentation? Are you serious?

That's what triage is all about. If done well, it pulls out the ones who need such. If not, and it is an art, bad things can happen.
 
Part of the problem is the two "rushes" to the ER that I see. The first one is 10 AM to 12 PM, followed by a longer rush at 5 PM to 10 PM.

People need to realize that if they show up to the ED at 6 PM for their sore tooth, or cough x 2 days, they will likely wait much longer than if they showed up in the late evening, or early morning.
 
Short ED wait times provide positive reinforcement for patients inappropriately accessing primary care.

Most private medical directors spend years beating that idea out of their doctors. An LWOB is lost money. Every fast-track type patient you don't see lowers your salary. If people want to come to the ED with their ear pain that I can dispo in 6.3 minutes flat (including paperwork) I say bring them on. I'll see them 10/hour and make a killing.

The only people with a right to complain about that are residents and military doctors.
 
This from the guy who picked up one patient in his first 2 1/2 hours last night! !!!
Hey now, it was 1 more patient than anyone else picked up those 2.5 hours. I can't make people come to the ED without spending time in jail.
 
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