Forum Seeks Solution for Emergency Room Problems
By Kristi E. Swartz, The Palm Beach Post, Fla.
Mar. 15–About 50 people filled a forum Wednesday on the state’s emergency health-care problems organized by the Florida College of Emergency Physicians.
Joining the group, which represents more than 1,100 emergency physicians in the state, were health-industry officials and members of AARP, as well as state Rep. Gayle Harrell, R-Stuart.
They talked about ways to solve the problems of jammed hospital waiting rooms, the shortage of on-call specialists and the lack of patient care.
While problems go unaddressed, people are dying who otherwise might be saved or at least see their lives prolonged with better care, said Dr. Michael Zappa, former president of the physicians group.
Zappa told of being unable to find an on-call specialist to treat a patient at Palms West Hospital in Loxahatchee. He began calling other hospitals. Eight hours and two dozen calls later, he found what he needed.
It wasn’t enough: The patient died during the ambulance drive to the other hospital.
“You know what this patient needs, and you can’t help them,” Zappa said. “You call around, and you beg and plead for someone to take your patient.”
But no one expects the state to take action anytime soon. Harrell, who chairs the House Health Care General Committee, said earlier that the issue “is not a high priority of the legislature.”
Without action, the problem is likely to get worse. More people are moving to Florida each year, but there are fewer hospitals to treat them, according to the panel. People can wait up to 18 hours in an emergency room before they are treated. And nearly one-quarter of the patients who walk into ERs don’t have insurance.
One issue, panelists said, is that about half of the students at medical schools in Florida complete their medical residencies outside Florida and are likely to stay there.
“We educate doctors that go off to other states,” Harrell said.
Money to pay for medical residencies comes from Medicare. A bill that would increase that amount, some of which could go to Florida for additional residency slots, is pending in Congress.
Panel members suggested urging private hospitals to give on-call doctors immunity from malpractice to encourage them to work. They also noted the need to handle the plethora of uninsured patients so doctors and hospitals can be reimbursed.
At the same time, doctors are less interested in working in emergency rooms to begin with, said Michael Gentry, the president and chief executive officer of the Florida Hospital Memorial System, which comprises three hospitals in Ormond Beach and Palm Coast.
Doctors’ lifestyles have changed to where they aren’t willing to be called into a hospital at odd hours.
“Society has changed the definition of success,” Gentry said — the days of doctors wearing a pager and leaving parties or getting up in the middle of the night are gone.
“Now it’s being home with my family for supper and not being interrupted while I’m eating,” Gentry said. “And there’s nothing morally wrong with that.”
Dr. Andrew Agwunobi, secretary for the Florida Agency for Health Care Administration, said any solution to fixing crowded waiting rooms and the shortage of specialists should be statewide or regional. He also said his agency needs to be more proactive in finding a way to ease crowding in hospitals.
Local doctors and hospital executives have been trying to devise a solution for two years, to no avail. Now, the Health Care District of Palm Beach County is formulating a plan, but any effort would take at least a year to implement because it would need state and federal approval and the agreement of area doctors and hospitals.
Staff writer Phil Galewitz contributed to this story.
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