Why hos­pi­tals are ad­ver­tis­ing ER wait times

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Whether by Droid, web­site, text mes­sage or bill­board, hos­pi­tals are ad­ver­tis­ing the wait times in their emer­gency rooms with greater vis­i­bil­ity than ever, as con­sumers press for ways to com­par­i­son shop for all types of care.

But as the prac­tice of ad­ver­tis­ing ER wait times has spread from highly com­pet­i­tive health­care mar­kets such as South Florida to re­gions across the coun­try, crit­ics say the trend is some­what trou­bling be­cause the wait times can con­fuse con­sumers while ben­e­fit­ing hos­pi­tals’ bot­tom lines.

The most fre­quently cited con­cern is that a pa­tient with a true med­i­cal emer­gency such as a stroke or chest pains might choose to go to a hos­pi­tal far­ther from home based on the ads— even though such clearly emer­gent pa­tients would get first pri­or­ity in any ER.

Pro­po­nents say the ads are in­tended to at­tract those cases that hover in a gray zone be­tween need­ing ER care and a clinic visit af­ter nor­mal busi­ness hours, such as sprained an­kles and sore throats. Not coin­ci­den­tally, those quasi-emer­gency cases also are likely to be pa­tients who have in­surance or other means of pay­ing for their care.

The ER ad­ver­tis­ing trend also comes at a cu­ri­ous time. Av­er­age ER wait times are as high

More hos­pi­tals be­gin ad­ver­tis­ing wait times for their ERs, em­pha­siz­ing that the tar­get pa­tients aren’t the true emer­gency cases

as ever, ac­cord­ing to stud­ies, and hos­pi­tal ad­min­is­tra­tors have said in nu­mer­ous hos­pi­tal as­so­ci­a­tion sur­veys that the emer­gency room care re­quired by a larger pop­u­la­tion of unin­sured pa­tients has driven many into fi­nan­cial turmoil.

But the chal­lenges of ER care is no news flash. It was only four years ago that a study by the In­sti­tute of Medicine, Hos­pi­tal-based Emer­gency Care at the Break­ing Point, con­cluded that hos­pi­tal emer­gency depart­ment over­crowd­ing was brew­ing into a na­tional cri­sis.

“Con­ven­tional wis­dom holds that EDs are the most ex­pen­sive source of am­bu­la­tory care and that ev­ery ef­fort should be made to di­vert none­mer­gent care from hos­pi­tal EDs,” ac­cord­ing to a 2001 Trend­Watch re­port from the Amer­i­can Hos­pi­tal As­so­ci­a­tion on grow­ing con­cerns about ER over­crowd­ing.

So if emer­gency care is ex­pen­sive, and hos­pi­tal ad­min­is­tra­tors have been com­plain­ing about ER overuse for years, why are hos­pi­tals in Ari­zona, Florida, Michi­gan, Vir­ginia and else­where ad­ver­tis­ing to cap­ture a larger mar­ket share?

Ob­servers say fi­nan­cial con­sid­er­a­tions are at play, both in the strug­gle to keep ad­mit­ting greater num­bers of hos­pi­tal in­pa­tients through ERs, and with the on­go­ing strug­gle with non­aligned ur­gent-care clin­ics.

“In gen­eral this is an in­ter­est­ing idea. But let’s get it straight. It’s about get­ting those pa­tients who re­ally have the op­tion of go­ing some­where else. This is not about get­ting pa­tients who have true emer­gen­cies,” says San­dra Schneider, a physi­cian in emer­gency medicine in Rochester, N.Y., and pres­i­dent of the Amer­i­can Col­lege of Emer­gency Physi­cians. “This is their way of com­pet­ing with ur­gent care. Emer­gency de­part­ments see a lot of pa­tients that ur­gent care could see.”

Pro­po­nents of such ad­ver­tis­ing say strug­gles for mar­ket share or fi­nan­cial gains are only part of the story, say­ing that bal­anc­ing the loads at var­i­ous ERs, im­prov­ing trans­parency and giv­ing pa­tients more choice are the real driv­ers.

Jack Mit­s­tifer, chair­man of emer­gency medi-

At six-hos­pi­tal Detroit Med­i­cal Cen­ter, ad­ver­tis­ing the wait times for the sys­tem’s ERs is noth­ing new. It’s been tout­ing a wait­ing time “guar­an­tee” since 2005.

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