The Doctor Will See You NOW!

Typical scene at a local emergency room

Typical scene at a local emergency room

If you’re looking for the front door of a hospital and assume it’s under the grand awning, straddled by ornate Corinthian columns and under a brightly lit sign reading “St. Elsewhere,” you’d be wrong. Most hospital administrators might not like to admit it, but the front door is really through the emergency room.

By far, the lion’s share of patients admitted to most hospitals started their journey in the emergency department: Patient’s walk into the emergency room under their own power, by wheelchair or on the gurney from an ambulance seeking rapid care and treatment. Today, two emergency room physicians challenge our thinking about going to the emergency room in an article they wrote for Time.com.

The headline; “McDonald’s Medicine: Are We Too Impatient to Wait for Care?,” seemingly suggests that many patients consider the emergency room their venue of choice for health care. They argue that convenience, speedy service and access to the latest medical technology drives consumers to the emergency room, and not to their own doctor’s office—assuming they even have a personal physician. The authors suggest that many of these patients could wait and see if their problem or condition improves with time. Not all emergencies are life–threatening they point out and suggest that primary care physicians explain to patients when they should use the emergency room, or wait until their physician becomes available.

Cconvenience? Speedy service? Most emergency departments are already filled with wall-to-wall patients; lying on gurneys or leaning in chairs, some hunched over emesis basins. Cries for “help me, help me, help me,” drowned out only by incessant equipment alarms long ignored by everyone—just the place you want to go for a quick check-up. I purport it’s fear of the unknown and the socialization of medicine from the internet that drives this demand.

Headaches are brain tumors. Nausea and vomiting, a heart attack in progress. Weakness is a stroke; happening now or getting ready to happen. Patient’s hear these horror stories while watching “Dr. Oz,” or read warnings from “Dr. Gott” in their local paper. Helpful friends and relatives ‘google’ their symptoms and open an electronic Pandora’s box of simply god-awful things the patient might have. Expecting physicians to counter this media barrage and help patients understand what should be seen now, or what can wait, is simply ludicrous.

Complaining that patients want access to medicine as fast as getting a Big Mac at McDonald’s is specious and disingenuous. The current health care system needs redesign and reorganization, accommodating the needs of all patients regardless of their expectations. Otherwise, as someone once said, “If we always do what we’ve always done, we’ll always get what we’ve always got.” We’ve got it alright—now let’s fix it.

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About Steve P. Sanders

A general internist writing and sharing ideas and art.

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