TheFluMaster
Resident
Report: ERs ill-prepared for mass casualties
SHERYL KORNMAN
THE TUSCON CITIZEN
Published: 06.15.2006
The nation's emergency-care system is overwhelmed and not prepared
to handle a mass medical emergency like a flu pandemic or a terror
attack, according to a report released Wednesday by the Institute of
Medicine.
Dr. Harvey Meislin, director of emergency medicine at University
Medical Center in Tucson, said the core problem in Arizona is "we
are under-bedded, we don't have enough specialists taking emergency
calls and we have to send patients to another hospital or out of
state because there aren't enough hospital beds or physicians."
The three-volume report said the nation's hospitals are so
overwhelmed with daily emergencies that they are not prepared to
handle mass casualties.
Meislin, a UMC emergency physician since 1980, agreed.
"Nationwide, we are becoming overwhelmed and we don't have the
appropriate response. The (federal) funding isn't there."
He said funding for preparedness, which he said "really has not
filtered down to the local level, where the rubber really meets the
road."
"Where are people going to go if there is this type of emergency?"
he said.
He pointed to bond funds recently approved by voters to expand
emergency services at University Physicians Healthcare Hospital at
Kino. That project won't be completed for about six years.
Meislin said most Tucson emergency departments still don't have all
the specialty physicians they need to take care of day-to-day
emergencies.
Because there is no limit on the amount of malpractice awards in
Arizona, the risk for doctors is high, he said, and neurosurgeons
and hand, neck and plastic surgeons here don't want to take
emergency-room calls.
"They want to stay with their elective surgery practice," Meslin
said.
Also, emergency medicine doctors are reluctant to come to Arizona
because their malpractice risk is higher here than in other states,
Meislin said.
But in some ways, "we are way ahead of the curve," he said.
Tucson's emergency-care system ended hospital emergency-room
diversion here more than a year ago by making improvements in the
system.
Now a hospital emergency department can't go on "divert status"
unless it is on "disaster protocol," meaning the entire hospital is
overwhelmed, Meislin said.
But, he said, "We are still underbedded" and don't have enough
medical specialists to meet the demand for emergency specialty care.
As a result, patients who come to UMC are sometimes sent to other
local hospitals, to other Arizona cities and other states for
specialty emergency care, he said.
Meislin called the report's summary "phenomenal" for its depth of
investigation of emergency-care issues nationwide.
The American College of Emergency Physicians called the
report "groundbreaking" and its president, physician Rick Blum,
called for a congressional hearing on the state of emergency
medicine.
Arizona's problems are the result of rapid population growth and a
shortage of physicians and nurses, said Dr. Todd Taylor, vice
president for public affairs of the Arizona College of Emergency
Physicians.
Arizona is the second-fastest growing state in the nation with a 65
percent population increase expected by the year 2020, according to
the Arizona Hospital and Healthcare Association.
The Institute's report said more of the people coming to the
emergency room are very sick and need hospitalization, but there
aren't enough beds for them so they must wait hours to be admitted
to a room.
Arizona ranks 49th in the nation in the number of hospital beds per
capita with 1.9 patient beds per 1,000 population. The national
average is 2.8 inpatient hospital beds.
The Arizona hospital group noted the shortage of physicians in the
state as a reason more people end up seeking emergency care - they
can't get in to see a doctor.
Arizona's physician-patient ratio is 207 per 100,000 people - below
the national average of 283.
University Medical Center administrators say the demand for
emergency medical services by illegal immigrants injured in rollover
vehicle accidents is also straining capacity.
The study was funded by the U.S. Department of Health and Human
Services and Centers for Disease Control and Prevention.
http://www.tucsoncitizen.com/daily/local/15948.php
SHERYL KORNMAN
THE TUSCON CITIZEN
Published: 06.15.2006
The nation's emergency-care system is overwhelmed and not prepared
to handle a mass medical emergency like a flu pandemic or a terror
attack, according to a report released Wednesday by the Institute of
Medicine.
Dr. Harvey Meislin, director of emergency medicine at University
Medical Center in Tucson, said the core problem in Arizona is "we
are under-bedded, we don't have enough specialists taking emergency
calls and we have to send patients to another hospital or out of
state because there aren't enough hospital beds or physicians."
The three-volume report said the nation's hospitals are so
overwhelmed with daily emergencies that they are not prepared to
handle mass casualties.
Meislin, a UMC emergency physician since 1980, agreed.
"Nationwide, we are becoming overwhelmed and we don't have the
appropriate response. The (federal) funding isn't there."
He said funding for preparedness, which he said "really has not
filtered down to the local level, where the rubber really meets the
road."
"Where are people going to go if there is this type of emergency?"
he said.
He pointed to bond funds recently approved by voters to expand
emergency services at University Physicians Healthcare Hospital at
Kino. That project won't be completed for about six years.
Meislin said most Tucson emergency departments still don't have all
the specialty physicians they need to take care of day-to-day
emergencies.
Because there is no limit on the amount of malpractice awards in
Arizona, the risk for doctors is high, he said, and neurosurgeons
and hand, neck and plastic surgeons here don't want to take
emergency-room calls.
"They want to stay with their elective surgery practice," Meslin
said.
Also, emergency medicine doctors are reluctant to come to Arizona
because their malpractice risk is higher here than in other states,
Meislin said.
But in some ways, "we are way ahead of the curve," he said.
Tucson's emergency-care system ended hospital emergency-room
diversion here more than a year ago by making improvements in the
system.
Now a hospital emergency department can't go on "divert status"
unless it is on "disaster protocol," meaning the entire hospital is
overwhelmed, Meislin said.
But, he said, "We are still underbedded" and don't have enough
medical specialists to meet the demand for emergency specialty care.
As a result, patients who come to UMC are sometimes sent to other
local hospitals, to other Arizona cities and other states for
specialty emergency care, he said.
Meislin called the report's summary "phenomenal" for its depth of
investigation of emergency-care issues nationwide.
The American College of Emergency Physicians called the
report "groundbreaking" and its president, physician Rick Blum,
called for a congressional hearing on the state of emergency
medicine.
Arizona's problems are the result of rapid population growth and a
shortage of physicians and nurses, said Dr. Todd Taylor, vice
president for public affairs of the Arizona College of Emergency
Physicians.
Arizona is the second-fastest growing state in the nation with a 65
percent population increase expected by the year 2020, according to
the Arizona Hospital and Healthcare Association.
The Institute's report said more of the people coming to the
emergency room are very sick and need hospitalization, but there
aren't enough beds for them so they must wait hours to be admitted
to a room.
Arizona ranks 49th in the nation in the number of hospital beds per
capita with 1.9 patient beds per 1,000 population. The national
average is 2.8 inpatient hospital beds.
The Arizona hospital group noted the shortage of physicians in the
state as a reason more people end up seeking emergency care - they
can't get in to see a doctor.
Arizona's physician-patient ratio is 207 per 100,000 people - below
the national average of 283.
University Medical Center administrators say the demand for
emergency medical services by illegal immigrants injured in rollover
vehicle accidents is also straining capacity.
The study was funded by the U.S. Department of Health and Human
Services and Centers for Disease Control and Prevention.
http://www.tucsoncitizen.com/daily/local/15948.php