Medical emergency

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Monday, Dec. 31, 2007 | midnight

Emergency rooms already overwhelmed by people seeking treatment are facing another problem -- a shortage of specialists.

Medical experts told The Washington Post that the lack of specialists in emergency rooms means patients often have to wait days before being evaluated and that can have tragic consequences.

“It can mean death,” said Dr. Linda Lawrence, president of the American College of Emergency Physicians. “Patients have died in transport, or waiting to find a neurosurgeon, or getting to a heart center for a cardiologist.”

A survey by Lawrence's group last year showed that nearly three-quarters of the nation's emergency rooms didn't have enough specialists on call to handle their workload.

Dr. Ann O'Malley co-authored a study on the lack of specialists for emergency rooms for the Center for Studying Health System Change in Washington. She said it is not an issue of numbers.

Doctors' reasons for declining on-call work assignments are understandable: They don't always get paid for treating patients without insurance, the schedule is inconvenient and the possibility of being sued for malpractice can be exacerbated in emergency medicine.

A separate study by the American College of Emergency Physicians gave the nation's emergency rooms poor marks because of the facilities' inability to provide patients access to quality and expedient care, citing a lack of space and specialists.

This is a difficult issue to solve because of the complexities of insurance and the health care system. The bottom line, however, is simple, as Lawrence notes.

“Something people don't understand is that even if you have insurance, if I don't have an on-call orthopedic surgeon, I can't help you,” Lawrence said. “It's an issue that affects everybody, insured and uninsured. If there's no bed available, there's no bed available.”

Anyone in the Las Vegas Valley who has visited an emergency room should be able to understand that. The emergency physicians' group wants Congress to create an independent panel to study the issue and find ways to improve access to emergency rooms. That would be a good start.

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