We invite you, dear reader, to have your head exploded by the contents of these three disparate articles on the matter of emergency departments:
First, there is Examining the ED’s Value Proposition (Rick Bukata MD, Emergency Physicians Monthly, 3/10/11), in which longtime ED hand Dr. Bukata takes his fellow ED physicians, and hospital execs, and anyone involved with ED care delivery, to task, for, among other things, making people wait. While he does address other shortcomings, the “keeping people waiting” issue is his centerpiece.
Then there is Bleeder to Feeder: How an ED Turned Its Business Around (Philip Betbeze, Healthleaders Media, 3/11/11), wherein Mr. Betbeze recounts the case study of a hospital that overhauled its ED practices to increase ED volume – mostly by not losing people as patients who leave because they had to wait too long. Said the hospital’s president, “We were effectively turning away 5,000-7,000 people a year,” he says. “Everyone who left told 10 more people that you can’t get in here.” He added, apparently without reflection on the possibility that an ED might have alternative clinical purposes, “The ER is the driver for operations.”
After this instructive example of the making of good changes for “bad” reasons, we conclude withChallenge the constitutionality of EMTALA (Lucy Hornstein MD, KevinMD, 3/11/11), in which Dr. Hornstein posits overturning the Reagan-era EMTALA statute mostly as a means of challenging the motives of those who would do away with the Obama-era health reform statute. The thing is, we’re not sure her assumption of the ‘absurdity’ of discarding EMTALA is on all that sound a footing. That is, maybe revisiting EMTALA would actually make for better health reform?Tweet