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ER Visits Often Long, Traumatic

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By STEVE OTTO

sotto@tampatrib.com

Published: February 10, 2009

This week you told me about your experiences in waiting rooms at Tampa Bay area hospitals in response to a column about a personal experience with an 87-year-old woman. You wrote me about what I think is every hospital in the region, from Sebring to Ocala.

I also heard from doctors and administrators, including a couple of them who thought I shouldn't have been in the emergency room at all; that emergency rooms are reserved for what they consider true emergencies and that too many of us use these facilities in lieu of primary care physicians. Here are a couple of the hundreds of letters and e-mails. You'll get the idea:

•"I went to St. Joe's St. Joseph Hospital's emergency room at 7:00 a.m. in terrible stomach pain and was seen after lying in the fetal position in the waiting room, crying for 31/2 hours. ... I was poked and prodded and waited until 8 p.m. and then rushed in for an emergency appendectomy."

- Tama Hillman

•"Welcome to the club. Mom's condition was brought on suddenly (so ill she could barely sit upright). We arrived at 1:00 p.m. at University Community Hospital. There were about 20 people waiting to be seen in the emergency room. Hours went by! More hours went by. I was trying to keep my mother from passing out. ... Mom was being 'bumped' further down the list. The problem was that I didn't know what was wrong with her. ... She was finally seen at 11 p.m."

- Ron

• "Brandon Regional Hospital is just as bad as TGH. I went to the emergency room with my sister last year around 6:00 p.m. and she was admitted at 6:30 in the morning. She went because of chest pains and shortness of breath which ended up being pneumonia. Almost everyone in the ER waiting room had a pan to throw up in and there was standing room only. She told them her resistance was low while on chemo, etc., but nothing was done. ... Something has to be done about this. ... This is not the medical care that one expects in this country. It should be unacceptable."

- Bettie Johnson

• "I am an emergency room physician in Tampa and wanted to apologize for your extended wait, but also wanted to give you some insight as to the reasons behind the delay.

"The federal government passed a law called the Emergency Medical Treatment and Active Labor Act in 1996 in the face of the increasing number of reports that hospital emergency rooms are refusing to accept or treat patients with emergency conditions if the patient does not have medical insurance.

This law, which is poorly defined at best, requires all emergency rooms to see all patients that check into an emergency room regardless of their medical complaint and perform some sort of medical screening exam.

Although this was well intentioned, its lack of clear guidelines has made it so all patients checking into an emergency room get a large-scale medical evaluation so as to avoid federal scrutiny or a malpractice lawsuit from zealous malpractice attorneys.

A combination of other factors, including the inability of patients to be seen by their primary care doctor for weeks to months should an illness arise and the lack of access to care for the staggering, and growing, number of uninsured other than in an emergency room where no upfront co-pay is required has made our numbers swell exponentially.

"Without government intervention to improve access to care and serious tort reform to encourage specialists to take ER calls, I am afraid the situation will only continue to worsen."

Michael McFarland, M.D.

Keyword: Otto Graphs, for more of Steve Otto's musings.

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