got public health?

Hello! Welcome to the Emergency Medicine and Public Health section of Receiving. The goal of this section is to put forward public health topics and generate thoughts and discussions about these topics.   All are welcome to contribute!  The more input from people, the more we learn.

Elections and the ED

It is nearly impossible to turn on the television or radio, or read a newspaper or the Internet without the presidential debate as a top issue—-actually, you’ll often hear it discussed during a shift.

Actually, I think it would be great for some of our attendings to get together and debate!

While topics such as the economy, taxes and foreign relations are big during the debates, there is one issue pertinent to the field of emergency medicine…ED overcrowding. With a 6X next to many patient names, our ED is a prime example of a growing problem around the country. Unfortunately, many EDs do not have the space to “board” patients, and consequently, patients are seen in the middle of hallways.  This leads to concerns to patient discomfort and safety hazards. ED overcrowding is a public health issue on so many levels: access to health care and affordable health care, increasing number of under- and uninsured, ambulance diversion, and in some institutions, long wait times in non-patient care areas.

The September 2008 edition of Annals of Emergency Medicine (vol 52, number 3, pg 265) attempts to address the differences in health plans between the presidential candidates. As ED overcrowding is an issue on the forefront, their plans are discussed and compared on areas such as health insurance and their financial plans for supporting the proposed plans. In 2005, the CDC reported 115 million visits that occurred to emergency departments nationwide, which is a 20% increase over the last 10 years. Yet, there was a 9% decrease in the number of open hospital EDs. In response to the growing concern, multiple studies have been conducted regarding ED overcrowding…the problem is addressing the issue and implementing solutions.

On a personal note, I think we’re fortunate to work in an ED such as DRH that, despite our large volume, we have the physical space for our patients—although there are plenty of times when we are crowded, our patients are not found in a hall being squeezed next to a wall or near our supply equipment. (This is unless I’m running the module and my patients are in chairs outside the module sharing their chief complaints—no joke)!

Thanks for reading.

Your comments and thoughts are much appreciated!

Dr. Marjan Siadat is a second-year Emergency Medicine resident at Detroit Receiving Hospital, Wayne State University. She is the editor of the public health section for Receiving.

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