Eliminate ER Wait Times
Eliminate ER Wait Times Wouldn’t it be great if every time you went to the ER, you got checked in right away and were given a room immediately? No more spending your entire visit on a hallway bed or behind a curtain—or worse yet, waiting in triage! Wouldn’t it be amazing if you saw a doctor very soon after arrival? I mean, after all, you went to the ER because you thought you had an emergency, and emergencies are time-sensitive.
Do you know how to make that happen?
Stop going to the ER for every stupid little thing that doesn’t actually require the ER! And to be clear, that is a whole lot of what I see in the ER that’s keeping me from seeing the things that really matter. That’s keeping me from seeing you in your moment of need.
(The obvious caveat to this is that the ER is pretty good at triaging true emergencies from trivial things. But I still have to see all of them. I have to see the trivial complaints, the serious complaints, and the critical complaints. Let’s talk about weeding out the trivial before they even get to the ER.)
Did you try over-the-counter medication first? For virtually any minor ailment you think you have, there’s an over-the-counter remedy at the drugstore—Walmart, Walgreens, CVS, Target, you name it. There are entire aisles dedicated to your problem. Pick something. Anything. By the time you drive to the store, buy it, and try it, more time will have passed—and chances are you’ll realize it was a spur-of-the-moment panic and you don’t actually need the ER after all.
If your kid has a fever, stay home. As previously discussed, fevers are almost never dangerous, and context matters. If your kiddo is otherwise pretty well-appearing, treat the fever (or not) and stay home. The vast majority of the time, fevers in kids are from viral illnesses and not more serious things.
If you think you have a sprain or strain in an extremity or joint, stay home. It can wait a day for an X-ray. Do you know how often orthopedic docs take broken bones to the operating room in the middle of the night or even the same day? Almost never! Things have to be really smashed, or bones have to be sticking out of the skin, for that to happen. So yes, if that’s the case, come to the ER. If not, make a clinic appointment for the next day. There are same-day orthopedic urgent care places all over town. They’re happy to see you—they love the business—and they’ll refer you to the specialist you need. I’m not waking anyone up in the middle of the night to call a specialist for something they’d normally handle in the clinic the next day. I’m only calling a specialist if it’s one of the truly emergent problems: a completely mangled limb, bones in tiny pieces, or bone protruding through the skin.
If you think you tore your ACL, stay home. Same logic as above. Whatever rotator cuff, ligament, meniscus, or other soft-tissue injury you sustained can wait. You don’t need an MRI in the middle of the night. Most of these injuries heal with conservative treatment—i.e., rest, OTC meds, physical therapy—and never go on to need surgery. So getting an immediate MRI is a waste. If things aren’t improving as expected, you may need an MRI eventually.
Let’s consider that maybe you do have a severe knee injury, for example. Let’s say you really did injure your ACL, MCL, and medial meniscus. This is a common “triad” knee injury pattern if the knee is struck from the lateral side—for instance, when a football player is tackled from the side and the foot stays planted while a large force is applied to the knee. Even if you will require surgery, it’s not happening in the middle of the night. Unless you are an NFL running back, you don’t need the MRI in the middle of the night. You are still better off going to an orthopedic urgent care the next day. Although these places are not open 24/7, they are open 7 days a week, and if you have an injury, they have a plan for you. It’s their entire business model: see any and all orthopedic injuries, funnel them into their system, and do it better than the competing group of ortho docs across town.
If your kid has abdominal pain, try these three tried-and-true remedies first:
- Eat something.
- Try to poop.
- Lie down for a couple of hours and see if it doesn’t feel better.
If you have any sort of viral illness, nobody in the ER cares—and we can’t do much anyway. It doesn’t matter if it’s influenza, COVID, another coronavirus, adenovirus, rhinovirus, or whatever other virus that is causing your laryngitis, bronchitis, sore throat, nasal congestion, runny nose, headache, body aches, cough, or fever. The treatment is chicken soup. Big Medicine has nothing better.
Treat the fever if you want (you don’t have to—your body fights infections better with a fever). Stay hydrated. You don’t have to eat; fasting is the body’s natural response when it’s healing. Get more sleep. Feeling fatigued is normal—rest more. That’s your body trying to heal itself. Fever, fatigue, and fasting—that’s what the body does to fight infection. And all of it takes time. I have nothing better to offer you in the ER.