IS OUR HEALTH CARE SYSTEM ON LIFE SUPPORT?

How long before you call 911 and hear elevator music interspersed with a robot voice saying: “Your call is very important to us. Please stay on the line and an operator will be with you shortly.”

That’s what we’re coming to. Some places are there already. Next time you have a medical emergency, you may not get the treatment you need. After waiting for your 911 call to be answered, you might wait a long time for an ambulance. A health care professional who worked in hospitals around the country for the past few years is telling me that our emergency rooms are so jammed, patients they used to be able to save are dying.

There aren’t enough nurses. There aren’t enough doctors There aren’t enough aides. There aren’t enough EMTs. It was a critical situation almost everywhere prior to onset of Covid. Writing three weeks ago in US News & World Report, ER physician Sharon Anoush Chekijian said: “Even before the pandemic, it felt like the emergency department was shouldering the lion's share of primary care: We'd provide treatment for hypertension, refill prescriptions when calls to the doctor's office went unanswered and manage chronically elevated blood sugar. Behavioral health patients with nowhere else to go would arrive one after the other by ambulance… Now COVID-19 has laid bare medicine's house of cards.”

Our ERs are teetering on the edge. The recent vaccination mandate from Maine Governor Janet Mills caused a surge of staff resignations, as have similar mandates across the country. According to the October 1st Lewiston Sun-Journal: “‘It has a huge impact on the existing labor shortage,’ said Dr. John Alexander. Central Maine Healthcare is the parent organization of Central Maine Medical Center (CMMC) in Lewiston, Bridgton Hospital and Rumford Hospital, as well as Maine Urgent Care and a primary care network. ‘In addition, to be honest, a lot of the people, a lot of frontline caregivers who have worked through this pandemic are tired,’ he said.”

I asked the health care professional who first alerted me to the problem why hospitals don’t just hire more staff. She said they’re just not out there and nursing schools aren’t graduating them fast enough either. Neither is there enough staff qualified to teach nursing students. Salaries at all levels are way too low. Hospital administrators. However, are paid well. Ten years ago the CMMC CEO was paid over $857,000 for fiscal 2011. What is it today? I wasn’t able to find data. My guess would be over a million per annum.

The Emergency Medical Treatment & Labor Act (EMTALA) passed in 1986 mandating that emergency rooms treat everyone who shows up. They must be screened, stabilized, then passed on to an appropriate hospital or they stay in the ER.

ER staff see patients suffering and dying every shift for lack of care. They see loved ones grieving too. CEOs do not see these things. They see spreadsheets of profit and loss. Kate Wells of Michigan Radio writes: “Inside the emergency department at Sparrow Hospital in Lansing, Michigan, staff members are struggling to care for patients showing up much sicker than they’ve ever seen.Tiffani Dusang, the ER’s nursing director, practically vibrates with pent-up anxiety, looking at patients lying on a long line of stretchers pushed up against the beige walls of the hospital hallways. “It’s hard to watch,” she said in a warm Texas twang. But there’s nothing she can do. The ER’s 72 rooms are already filled. “I always feel very, very bad when I walk down the hallway and see that people are in pain, or needing to sleep, or needing quiet. But they have to be in the hallway with, as you can see, 10 or 15 people walking by every minute,” Dusang said. …“I cannot tell you how many of them [the nurses] tell me they went home crying” after their shifts.” 

Dr. Chekijian in US News says: “The bottom line is this: The house of medicine in the U.S. is a house of cards that has already started its crashing descent into collapse.” 

I just turned seventy last spring and this is a disconcerting scenario for my demographic, the cohort most likely to need health care. Prone to chronic blood clots, I’ve spent many hours in emergency rooms over the past thirty years, the last few times on a stretcher in a hallway because the ER was overcrowded. I watched nurses scurrying about trying to tend to us all and hated to add to their stress by asking any more of them.

The last time I did that was three years ago. What will it be like the next time? I hate to think.