Misconceptions about the Emergency Room

Apr 22, 2018 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Emergency rooms have been known to be one of the most effective fields of medicine in resource utilization. They are able to tap into all of a hospital’s resources in one place and can do in hours what otherwise would take days if a patient was sent from office to office for testing, specialty expertise and pharmacy.
As efficient as emergency rooms are, they do tend to occasionally experience negative publicity. Negative publicity in the emergency setting is an expected part of the practice and can be used constructively to improve the efficiency of function of the system. However, there are instances where the public view of an emergency room is unwarranted, and creates unnecessary fear and anxiety in the population.
Misconceptions or false statements about emergency rooms and its staff are of no benefit to system in general. It is therefore important that we highlight three common misconceptions about the emergency room in an effort to appease some of the anxiety created about emergency room care.

Myth: If you want to die you should go to the emergency room

This is a common utterance by some in society. Patients that come to the emergency room are generally very sick or injured, and even terminally ill at times. These patients sometimes wait too late to come or are sometimes neglected and brought at inopportune times to the emergency department.
The emergency room staff is tasked with the difficult situation of battling to save most these patients on a daily basis. The reality is we can never be a hundred percent successful. It is often said that we will fight for a hundred lives and lose one in the process. No one will ever hear of the ninety-nine saved, but we will be chastised for the one that died. Maybe it was a rare human error or it was that patients’ time, the reality is that we are looked at as a failure based on that one patient.

Myth: The Emergency room will fix all of my problems

Everyone is entitled to a courteous visit to the emergency room just as you are entitled to a courteous visit to a bank. If you order a pan of pizza at a bank, you can’t have it, no matter how upsetting this may be or how much you may want it.
A 2012 study published in Journal of the American Medical Association showed that higher patient satisfaction scores are associated with higher health care costs and higher death rates.
Patients frequently enter the emergency department expecting antibiotics for the common cold or a CAT scan of the head. They equate patient satisfaction with “customer satisfaction.”
While it’s very trendy to say so, patients are not exactly customers. Physicians have a trustee role to maintain, as most of us know what can harm humans, and are ethically and legally bound not to administer it.
In many emergency departments, you may be able to demand more tests, but you should know that receiving them may not always be in your best interest.
We probably won’t be able to diagnose a skin rash that’s been present for three years, nor we may not be able tell you exactly why your toe hurts if it’s not broken. The emergency room is designed to identify and treat time-sensitive, life-threatening conditions.

Myth: I will be seen quicker if I go to the emergency room

This is not always true. Patients are seen according to their level of urgency and not necessarily by the time of their presentation. A patient that comes in with a heart attack will always be seen before a patient who was waiting to be seen for his knee pains. There will always be critically sick or injured patients, and these patients will always have to be given priority. The reality is average emergency patient wait times can vary from about two to eight hours depending on the country. That’s a long time, especially if you compare that to other care options like health centres, where the average wait time rarely exceeds two hours.
As emergency physicians we see daily what others get to experience maybe once in their life. I have seen lives lost in moments of agony but have also seen life snatched from the jaws of death. Fighting to save a life against the odds with the expectation of success is what we do. These constant life-saving acts that do occur are for the medical staff to experience, and out of respect for our patients, it will not be heard in public ears. In Emergency medicine what we do matters, and what matters is what we will always do.

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