From door to doctor, long waits in the emergency dept.

P enny Walker is feeling much better now, but on September 11th, she became violently ill. She says she was constantly vomiting, suffered an extreme headache and had difficulty standing up. Since it was a Sunday, Walker says her doctor told her to go to an emergency department. She chose Upstate University Hospital.

Walker says she arrived at 5:00 pm, "A lot of people were coming in. I'd wait like an hour or two, I would go up and ask the nurse at the desk, do you know if I'm going to be seen and how long?...They couldn't answer my question."

A t about 2:00 am after sitting in the waiting room , sick and throwing up for 9 hours, Penny Walker says the supervisor at the desk told her it would be another five hours before she could be seen, and if she needed to be admitted, there were no beds available. Walker says she left and went to Oswego Hospital, where she says she was treated the next day. "I wouldn't want anybody else to go through It. I think it's way too long to wait."

Upstate University Hospital CEO, Dr. John Mccabe told CNY Central's Jim Kenyon, "Emergency departments are busy and they're unpredictable because they're open all the time for anybody who happens to come in."

Dr. McCabe explains that while emergency departments are required to treat anyone who walks through the door , they're forced to prioritize patients according to a procedure called "triage." It sometimes means that a person with a life threatening condition like a heart attack or stroke would be seen immediately while a person with a broken arm may have to wait. But McCabe adds that the big advantage to an emergency department is that you get a full range of medical services that are not available in a doctor's office, without an appointment and you can't be turned away. "Considering that you can go anytime and get care you can't get elsewhere in the community, that actually is pretty good." he says.

The Executive Director of the Hospital Executive Council in Syracuse, Ron Lagoe says his organization has no hard and fast statistics on wait times, but he says the average "door to doctor" wait is between 3 and 4 hours. That would be slightly better than the National average which according to the American College of Emergency Physicians was 4 hours, five minutes in 2007.

Lagoe says Penny Walker's experience "sounds rather long. But it's not unusual for patients to wait several hours to receive care depending on their condition."

Lagoe says patients are crowding into emergency departments like never before. In 2001, the emergency departments at Syracuse's four hospitals; Community General, Crouse, Saint Joseph's and Upstate treated 145,696 patients. By 2010 the number grew to 175,365 patients. Lagoe says the volume of patients in emergency departments have been increasing at an average annual rate of 2.8 percent with no end in sight

He says there are several reasons. "Our population is getting older and people as they age, need more care, but I'm also attributing that to patient preference." He also says researchers in California found many patients in their 20's and 30's preferred emergency departments over primary care physicians. That's because they could be seen without an appointment, undergo diagnostic tests and receive treatment all at one place, plus they could not be turned away. Emergency departments fit their busy lifestyle, "They liked the idea of packing in the laptop at the end of the day, going in the waiting room, watching tv or emailing their friends, but they knew 5 hours later they're going to have it done." Lagoe said.

Lagoe says the four "urgent care" facilities, "provide a useful function", but only have a "minimal impact" in relieving overcrowded emergency departments. He says they mainly "pick up some of the slack for physicians after hours."

Dr. Richard Steinmann, the Emergency Medical Director at Crouse Hospital points out that, "trying to handle the increased volume without being able to build endlessly bigger and bigger facilities and hire more and more staff, health care costs being what they are, the necessity is to get more efficient."

Dr. S teinmann says by improving the efficiency of the emergency department and referring many patients to Crouse's Prompt Care facility across the street, Crouse is able to keep door to doctor wait times at an average of 1 hour and 15 minutes...but he says there are times when things get backed up. "One thing that we want to emphasize is that the docs and nurses hate making people wait. It's not why we get out of bed and come to work in the morning. We hate it almost as badly as the patients do."

What has been your experience waiting in an emergency room? Do you feel we should be investing in larger emergency Departments, or trying to find a way to cut down on the number of people who use them out of convenience?