Tuesday, February 07, 2006

Symtym Comments on Ambulance Diversion Studies

From Symtym (an ED Physician, law student / blogger):

The single greatest real threat to the U.S. healthcare system is the inability to surge capacity—almost all urban settings nationwide are affected. Present healthcare funding and "competition" has stripped any ability to surge capacity—leaving our healthcare system truly lean and mean. Contrary to the old adage about the "bird-in-hand," our attention and our ambulances are all diverted. Ambulances are diverted solely because that is the only surge in capacity the hospitals can control. Plain and simple, diversions are a sign of diseased hospitals—stricken with the disease of too little beds, too little staff, or a combination of both. Like ambulances, and the EMS system in general, the Emergency Department (ED) becomes the next stricken victim of this true nosocomial disease.

Those first stricken, like victims of scourges past, are perceived as the cause and are punished for their shortcomings. As in ages past, the truth is much more subtle and pervasive—ambulance, EMS, and EDs are just low hanging fruit on the diseased trees. Ambulances will cease to be diverted only when EDs cease to close, and EDs will cease to close only when the hospitals are cured of their insidious inability to meet healthcare demands.

One final point of clarity, the term should never be ambulance diversions or EMS diversions or ED diversions—it should be hospital diversions, because it is far more preferable and logical to name a disease after its cause, instead of its victims…else, what should we call the "bird flu?"


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