Emergency-room docs offer inside scoop: How to get treated faster, better
Nov 29th 2009 12:00PM
Updated Nov 30th 2009 12:19PM
Before seeing a doctor, expect to wait more than 55 minutes, the average ER wait time across the United States, according to the Centers for Disease Control and Prevention. Show up on a busy night or weekend and the wait could drag on for several hours.
There are plenty of ER horror stories, like the case of 49-year-old Illinois resident Beatrice Vance who arrived at the hospital complaining of chest pains, only to be found dead two hours later, still in a waiting room chair. But this doesn't happen every day. DailyFinance spoke with emergency-room physicians across the country to find out what moves patients can make to prevent experiencing a horror story of their own.
First let's debunk a persistent ER "shortcut" myth. If you or a loved one has a life-threatening emergency, by all means call an ambulance, as paramedics can immediately begin care as you're being rushed to a medical facility. But don't expect to get treated any faster for sunburn or a stubbed toe just because you arrive in an ambulance, emergency physicians say. You'll be triaged based on the severity of your condition, just like everyone else.
"We have people who've called an ambulance for earwax impaction or prescription refills," says one ER physician, who writes a blog called ER Stories. "When they come in by ambulance, they go right into the waiting room."
Here are some things you can do to be treated faster and better:
Avoid nights, weekends and holidays: Face it folks, doctors take time off, too, and you'll be seen more quickly if you show up at 10 a.m. on a weekday rather than 10 p.m. on Saturday night -- after there's been a series of car wrecks. "Even if it happens to be less busy on a night or weekend, the staffing is lower," the ER doc in the northeast says. "There may only be five people ahead of you, but it will take a while to get seen." Holidays are also a bad time to go, as is the day right after, as hospital staff may extend their vacations. True emergencies, of course, give little advance warning. But if you have an inkling your bandaged finger, say, may need stitches, best head to the ER as soon as possible, rather than waiting until after work when you'll have plenty of company.
Call your regular doctor before you go: If you let your primary care physician know you're heading to the hospital, he or she may be able to call ahead and alert the staff. Often, the ER department may even be able to hold a bed for you if your doctor requests it. "If the doctor wants us to call them back, we'll try to see the patient quickly, at least to give them an update," says Larry D. Weiss, president of the American Academy of Emergency Medicine. "The care is more coordinated." If at all possible, go to the ER at a hospital where your physician has "privileges," or the authority to provide patient care. What's more, your primary care physician may have you directly admitted to the hospital, bypassing the emergency room. "Not everyone has to come from the ER," he says.
Bring a list of your medications: Certain drug allergies or interactions can harm or even kill you. To begin treatment, doctors will ideally need to find out about all the medications you're taking. "People will come in and say 'I'm on five different drugs,' but that isn't as helpful as knowing the actual names," says Weiss, who is also a professor of emergency medicine at the University of Maryland School of Medicine. He recommends keeping the names of your medications on a card in your wallet. Or throw your medications into a bag and take them to the hospital to show the staff.
Have your medical records and tests handy: Another major slowdown for doctors in the ER can come from having to order medical records and tests from other hospitals or departments to get the full picture of your condition. Having copies of them will speed up the process, doctor say. "They may still need to order new blood tests," says DailyFinance columnist Russell Turk, who is an obstetrician and gynecologist in Connecticut. "But if they have a [previous] test, they have a much better idea of what's changed."
Make sure your hospital treats what's ailing you: Knowing ahead of time whether the ER to which you're heading actually has the right staff and resources to treat your problem will save you time. If your teeth get knocked out in a car crash but the hospital you visit has no dentistry unit, you may have to be transferred, costing valuable time. Same goes if you drop off a suicidal friend at a hospital that has no psychiatric ward. "The transfer may take days," warns the blogging ER doc. "It's not a bad idea to look at the hospital website" to see what its specialties are.
Try to be understanding: The reality of the ER is that unless you're dying, you're going to be treated after someone who is in much worse shape. "Going up to the nursing station and yelling and raising your voice about a relatively minor complaint is often counterproductive," says the ER blogger. That said, ER staff will be responsive if you have a reasonable request, he says. If your grandmother is in pain, for instance, let the staff know and ask if someone can assess her. "The doctor could see her quickly, at the very least to give her some pain medication," he says.
Bring somebody with you: It's likely that when you go to the ER, you won't exactly be feeling your best. It's always a good idea to bring somebody with you -- a spouse, perhaps, or a trusted friend -- who can help answer questions about your condition and recall any information the medical team gives. "If you're the patient in the ER, there might be situation where they're talking about certain problems and you'll want to have someone else there," says Turk. But if at all possible, don't bring along kids or others who could distract both you and the medical team.
Avoid the ER altogether: If you're suffering from an urgent -- but minor -- problem like a cut, ear infection, flu or animal bite, you may be able to go to an urgent care center instead of a hospital ER. Typically, patients are seen more quickly at urgent care centers. "From my perspective, if you have minor problem for which you are not going to need, say, a CAT Scan, go to an urgent care center as opposed a large hospital emergency room," Turk says. For more serious emergencies such as chest pain, poisoning, or head or spinal injuries, go to the ER after dialing 911, of course.
If you do end up at an emergency room some day, here's a little perspective: There are now about 1,100 -- or 22% -- less emergency departments across the United States than there were 20 years ago, while the number of ER patients has risen 33% to 120 million annually in the same period, according to the American Academy of Emergency Medicine. Because emergency rooms have such high overhead, hospitals are simply closing them to get rid of the burden, Weiss says. "It's really a huge mess."
Keeping these tips handy may make the mess a little more bearable.