Two weeks ago, there were a series of reports about an ER Crisis issued by the Institute of Medicine, a unit of the National Academy of Sciences in the US. Some of the alarming adjectives used were "understaffed" and "overwhelmed," and these send chills to a country that is always under the threat of mass casualties from a possible bioterrorism attack or a pandemic flu outbreak, or even another hurricane of the Katrina magnitude.
Annually, the ERs in the US received about 114 million patients, 16 million of these arrive by ambulance. The ER system in the US is the primary source of health care during evenings and weekends, and it accounted for 43 percent of all hospital admissions in 2002. In spite of this, it gets little budget and little training.
There's also the absence of key medical specialists like neurosurgeons in their ERs who fear nonpayment from uninsured patients, and skyrocketing malpractice premiums from the very risky nature of their specialty.
An editorial from Florida cites the unfortunate case of David Rosenbaum of the New York Times, who was mugged after having dinner, and was severely beaten by a pipe. The editorial said that Rosenbaum died after a series of incredible blunders by emergency personnel.
And I thought we had a worse situation here in the Philippines, where patients in government hospitals sometimes spend days waiting in ER stretchers because they can't get admitted. Then there's also the perennial reason of being "we're-full-already," and a subsequent order for transfer to another hospital is requested. You find out later that the real reason was the fear of nonpayment, because the hospital thought that the patients couldn't pay up. Again, these are all anecdotal. No one has done any study to document these cases. Maybe they don't need to. One has only to experience it to know.