Emergency Department

Turmoil among senior emergency physicians at Martin Luther King Jr./Drew Medical Center has allegedly erupted twice this month into threats of violence, prompting a judge this week to bar top county hospital officials from threatening one of the doctors. Tensions have mounted since late last year, when Dr. William Shoemaker was demoted from his post as chairman of the emergency department and replaced by Dr. H. Range Hutson.

A satisfied patient is not a cheaper patient: however important such a finding may be in these budget-constrained times, that comes as little surprise. More unexpected is the finding that a satisfied patient is not necessarily a healthier patient -- that the patient happy with the medical attention he or she receives from a physician is more likely to die than the patient who grumbles about it. Yet both findings emerge from a study published "online first" on Monday in the Archives of Internal Medicine . The authors -- four family medicine doctors at UC Davis -- suggest that in a healthcare marketplace in which Americans often choose their doctors in the same way they choose a plumber or an electrician, physicians may have gotten a little too eager to please their "customers.

A satisfied patient is not a cheaper patient: however important such a finding may be in these budget-constrained times, that comes as little surprise. More unexpected is the finding that a satisfied patient is not necessarily a healthier patient -- that the patient happy with the medical attention he or she receives from a physician is more likely to die than the patient who grumbles about it. Yet both findings emerge from a study published "online first" on Monday in the Archives of Internal Medicine . The authors -- four family medicine doctors at UC Davis -- suggest that in a healthcare marketplace in which Americans often choose their doctors in the same way they choose a plumber or an electrician, physicians may have gotten a little too eager to please their "customers.

Huntington Hospital is more than halfway done with an expansion of its emergency department as it seeks to keep pace with rising demand for emergency room services. The Pasadena hospital's emergency and trauma center has 21 beds. The new center will add 22,000 square feet and contain 50 beds. The $80-million expansion was fueled by several factors that have increased activity at Huntington's emergency room. The first came in 2002, when Pasadena's St. Luke Medical Center closed, making Huntington the hub for 90% of 911 calls in the area.

The Orange Coast Memorial Medical Center's Emergency Department recently received the 1999 Emergency Department of the Year award at the 25th annual California Emergency Physicians' Meeting. More than 45 emergency departments were considered for this honor. "We are pleased and very proud to receive the award," said Robert Realmuto, chief of emergency medicine. "This honor acknowledges the teamwork and dedication that our ER and the entire hospital puts forth daily for the care of all patients."

In 1995, some 162,000 children were treated in hospital emergency rooms for baseball-related injuries, according to statistics gathered by the American College of Emergency Physicians. Here are more numbers about injury in America: * Sports-related injuries suffered by older Americans increased by 54% between 1990 and 1996. * Injury prompts 54% of all visits to emergency departments by children ages 5 to 14.

I wish to endorse the sentiments expressed in your editorial ("Turning Away Rape Victims," Oct. 10) on Gov. George Deukmejian's veto of SB 2205, which would have funded emergency examinations for victims of rape and child sexual abuse. As the medical director of Northern California's largest emergency department for children, I fully subscribe to the philosophy that health care should be considered a right in the U.S. However, it is extremely irresponsible for political leaders to mandate unlimited emergency care without simultaneously addressing the issue of how this care is to be funded.

In what authorities described as a gang-related attack, a teen-ager was shot early Sunday morning in the emergency department waiting room of Daniel Freeman Memorial Hospital in Inglewood. It was the latest incidence of violence at a Los Angeles hospital emergency room. Last February, a man critically wounded three physicians in the emergency waiting area at County-USC Medical Center. During a six-month period in 1991, officials at County-USC logged 1,400 incidents of violence or threats.

St. Joseph Medical Center in Burbank withdrew from Los Angeles County's trauma network Monday, leaving officials from nearby hospitals fearing an increase in the number of critically ill patients they must treat. "We're not adding any more staff to handle the expected increase, but psychologically we're gearing up," said John McConnellogue, director of Northridge Hospital Medical Center's emergency department. St. Joseph officials announced in April that they were dropping out of the network because of a lack of funds.

The California Emergency Physicians group recently honored South Coast Medical Center's emergency department with its first-ever "ER of the Year" award. South Coast, a 210-bed nonprofit hospital, was distinguished as the top emergency room out of 50 California Emergency Physicians sites in the state. The department excelled in emergency care, patient satisfaction results, speed of service, treatment of heart attack victims and commitment to its mission, the group found.

Use of CT scans in hospital emergency rooms has risen 16% a year since 1995, raising questions about unnecessary radiation exposure and how healthcare costs can be contained against such fervent use of technology. In a study released Monday in the journal Radiology, researchers found use of CT ? computed tomography ? procedures increased from 2.7 million nationwide in 1995 to 16.2 million in 2007. The study joins several recent reports showing that the use of sophisticated imaging technology, and the cost associated with it, has grown rapidly.

About the only thing Dr. Philip Schwarzman can be sure of under the national healthcare overhaul is that he is adding his daughters, ages 23 and 25, to his health plan immediately. Much less clear to Schwarzman is how the sweeping law will affect the emergency department at Providence St. Joseph Medical Center in Burbank, where he is medical director. "It's incredibly complicated," said the white-haired physician, whose department sees 50,000 patients a year. "It's hard to predict what's going to happen."

Hospital officials report that the numbers of patients with H1N1 flu appear to be leveling off at many Los Angeles area hospitals, easing wait times at crowded emergency rooms less than a week before Thanksgiving. "We're seeing a tail off," said Rob Fuller, executive vice president at Downey Regional Medical Center. "The debate is whether this is the end of Round 1, or is there going to be another wave?" Although health officials cautioned that the course of the flu pandemic remains unpredictable, many said they were hopeful.

Harbor-UCLA Medical Center, one of the Los Angeles County health network's most heavily used facilities, is poised for a major expansion that planners hope will greatly relieve overcrowding. County supervisors voted Tuesday to approve the final piece of a $333-million plan to expand the Torrance facility's emergency department and renovate the surgical ward. The emergency room will grow from 25,000 square feet with 42 bays to 75,000 square feet with 80 bays, providing enhanced privacy.

Patients are waiting longer for care in the nation's emergency rooms, a potentially deadly result of the shrinking number of emergency departments and rising demand for services, according to a new study by researchers at Harvard Medical School. Half of all emergency room patients waited 30 minutes or longer before being examined by a doctor in 2004, a 36% increase from a median wait time of 22 minutes in 1997, according to the study, published Monday in the journal Health Affairs.

Re "County Feels Symptoms of Health Crisis," Aug. 29: Thank you for drawing attention to the growing emergency room crisis in Los Angeles County. Unfortunately, the county continues to melt down. Every day I see in the emergency department where I work continued and increasing long waits, delayed care and the indignity of a class of workers in our society deprived of adequate access to primary healthcare. The majority of my patients are the working poor, paying their taxes to state and federal healthcare programs and to Medicare, and getting nothing in return other than an increased chance of death because of the preventive care they never receive.

Harbor-UCLA Medical Center, one of the Los Angeles County health network's most heavily used facilities, is poised for a major expansion that planners hope will greatly relieve overcrowding. County supervisors voted Tuesday to approve the final piece of a $333-million plan to expand the Torrance facility's emergency department and renovate the surgical ward. The emergency room will grow from 25,000 square feet with 42 bays to 75,000 square feet with 80 bays, providing enhanced privacy.

It is extremely likely that your local emergency room is overcrowded and not prepared for the sudden surges in cases that are seen with an epidemic such as the flu, a natural disaster such as an earthquake or a man-made disaster such as an act of terrorism.

She wasn't complaining. She wasn't angry. She just wanted to know when an emergency doctor would see her. I glanced at her chart. To my shame, she had been waiting 17 hours for medical attention. Meanwhile, more than 30 admitted patients clogged the emergency department at Los Angeles County-USC Medical Center. One, an older man, was near death. He had what I've seen called in the media "flesh-eating bacterial infection."