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LAC+USC Emergency Room: Crowded Care

LAC+USC Emergency Room: Crowded Care

Picture of Barbara Feder Ostrov

At 7 p.m. on a Friday night, the waiting room of LAC+USC Medical Center's emergency department is crowded and will get worse as the hours tick by. This public safety net hospital sees, on average, 450 emergency patients each day, some for ear infections, others with gunshot wounds.

Despite the crowd of waiting patients, this is a relatively quiet night, emergency department director Dr. Edward Newton tells a group of California Endowment Health Journalism Fellows as he tours them through the ED.

The nation's emergency rooms are strained with patients who can't get medical care any other way, and LAC+USC is no exception. Unlike other emergency rooms in California and nationally, this one is in no danger of closing anytime soon, but Newton said budget cuts soon will eliminate 40 ED nurses, leading to longer waits for patients.   

"We're underfunded now, but I think that's about to get worse," Newton said. There's no fat in any of these hospitals. If you don't have a bed that's generating revenue (from a patient), you send that nurse home. We may look at these as the good old days."

Although LAC+USC's emergency department sees almost exclusively uninsured patients, more and more people, many with health insurance are crowding the nation's EDs, Newton said. In addition to rising numbers of the uninsured, insured patients also come to the ED because they can get immediate access to specialists and diagnostic tests such as MRIs. An aging population and rising rates of diabetes and other chronic diseases also pack the patients in.

"We're victims of our own success," Newton said. "We're always open. People don't have to take a day off work to deal with their kids' (ear infections). We can deal with anything you develop, medical or psychiatric or toxicological. You don't see that in an urgent care facility."

One bright spot: fewer gunshot wounds: the ED's trauma center now sees two or three cases each week, compared to 16 gunshot wounds each day in the 1980s, Newton said, attributing the decline to gang truces and California's three-strikes law.


LAC+USC Emergency Department: Dr. Edward Newton's PowerPoint presentation


Picture of Angilee Shah

I had missed this article on Slate, but it offers an interesting and different perspective on ERs:

Here's a snippet:

Overall, our ERs are working about as they ought to be. Dramatic news stories attempt to expose the problem of ER "hyperusers," such as the tale of nine patients in Texas, eight of them drug users, who were responsible for a whopping 2,700 ER visits in six years.* But ER abuse like this is the exception, not the rule. Most "frequent flyers"—a pejorative term used to describe patients who stop by ERs a lot—tend to be the very sick, those with severe asthma, heart failure, or diabetes. When these conditions flare up, patients do, and should, come to the ER. ERs are designed to take care of acutely ill patients, while doctors' offices are not.

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The outpatient 4p81 and 4p61 clinic is horrible, nobody is helpful . The nurses and rest of the staff were horrible and abusive. It seems to me that the people here are lazy.  Nobody that works there wants to be there, and I even  think that the med students and the doctors are lazy too,The med student are very unprofessional.

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Our ER is busy any night of the week. It is because people can't afford health insurance, or because they are undocumented. Sometimes, we get patients from Kaiser, White Memorial, and California Hospital. That's a lot pf people. And when you have that many people + the minimal amount of nursing personnel, your are going to have to wait. Our ED staff work very hard to care for every patient who comes through the door. It is true for the clinics too. Any body who has ever come to LAC/USC Medical center for medical problems knows that once you are there, you are going to have to wait. With the amount of staffing possible, our staff do their best to get people in and out of the clinic and the ER ASAP. LAC+USC is one of the best in the country. Coming here is worth the wait

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I think it is amazing how long some of the wait times for these emergency rooms are! We recently moved to Houston and ended up waiting 6 hours in the hospital ER waiting room, next time we plan on going to a freestanding emergency center in Houston, we’ve heard they have no wait times and can provide the same level of care!


The Center for Health Journalism’s 2023 National Fellowship will provide $2,000 to $10,000 reporting grants, five months of mentoring from a veteran journalist, and a week of intensive training at USC Annenberg in Los Angeles from July 16-20. Click here for more information and the application form, due May 5.


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