There's a reason it's called the EMERGENCY ROOM...

As an aspiring emergency medicine physician, one of the things that frustrates me most is the intentional misuse or abuse of the resources of the emergency department. It is not a place to be used as a primary care facility, nor is it a dispensary of your favorite narcotic. Anyway, this being one of my pet peeves, it shouldn't be terribly difficult to see why this article really irritates me. Look, I understand that it's natural to be worried about a loved one whom you've had to bring to the ER. But threatening to call the hospital president or CEO is not merely an obnoxious tactic but one that demonstrates extreme disregard for the emergency department staff as well as the other patients. What someone is essentially saying by doing this (or any of the myriad variations on this theme) is that he is more important than anyone else in that emergency department, and that he knows better than the trained (and presumably objective) physicians, nurses, and other staff who needs to be seen urgently. If you get bitten by a tick and are worried about an acute allergic reaction (Type I hypersensitivity, for those of you who are keeping score at home), fine. But if you don't have any of the signs of anaphylaxis, it's really not necessary for you to be seen before the guy experiencing chest pain or the woman complaining of an intense sudden-onset headache. But of course, if your egotism requires you to be seen before anyone else and you manage to pull the doc away from the other patients who have been designated by triage as more emergent, you won't be the one to suffer if someone else dies, will you? It'll be the physician's fault, the hospital's fault, for not doing enough.

I've had the privilege of working with some truly outstanding emergency physicians, and I hope to be able to number myself among them someday. But when they're dealing with a waiting room jam-packed with people convinced they have swine flu, when they're dealing with full trauma bays, when they're dealing with large and uncooperative patients, abrasive family members, patients exhibiting drug-seeking behavior, and with the ever-present threat of lawsuits should the smallest thing go awry with the wrong person, can you blame them if they're a little harried, maybe slightly stressed out or on edge? And now someone wants to insist on making life MORE difficult for them and the even busier nurses and ancillary staff? I'm sorry, that just doesn't sit well with me. If you're truly in an emergency situation (the hypothetical the author poses to the physicians in the article postulates a spouse in a life-threatening state), they'll recognize it and get you where you need to go. If not, they'll still keep an eye on you; it's not like they're just going to let you die in the waiting room if suddenly your immune system DOES decide to send you into anaphylaxis. Please, give the emergency nurses and physicians the credit they deserve -- they know what they're doing. If you honestly feel that you (or the person you're with) is getting worse, let the triage nurse know - politely - and you'll likely get a prompt re-evaluation. Otherwise, wait your turn and count your blessings -- you could be one of the patients in those trauma bays. Or in ICU. Or in the morgue.

Ok, that's my rant for the day. You can see a video associated with the story below; believe it or not, the video version is actually much more tolerable than the written article. She makes it a point to indicate the kinds of problems the ER staff faces on a regular basis, and makes generally more reasonable recommendations regarding how to alert ER personnel if you really think things are going south. Once again, any questions, comments, concerns, opinions, etc. would be greatly appreciated (from all two of you who read this blog...oh well...). Hopefully we'll return to happier topics tomorrow.

Peace and God bless!