Emergency Services

Demand for emergency room care in California has increased by 26 percent over the last decade while capacity has remained flat or declined in most service areas. Accordingly, some health care analysts recommend that hospitals be allowed to operate freestanding emergency departments (FEDs) to help meet a growing need in the state. FED supporters also believe that the enactment of health care reform will put greater stress on existing hospital emergency departments because as many as 40 hospitals in California, most with emergency rooms, will close in the coming years.

One of my most vivid childhood memories was when, as a teenager, I broke my arm playing softball at school. The pain was excruciating, but it was the quest to get medical treatment for my fractured appendage that is most memorable. The private hospital closest to my school in South Central Los Angeles turned my mother and me away because I had no medical insurance.  As a consequence, with my arm resting on a clipboard, we had to take a very long bus ride to the county hospital in East Los Angeles where I finally received treatment after enduring many hours of extreme pain.

Emergency department (ED) on-call systems are on the brink of disaster. Spiraling downward nationally, they fare even worse in California. It’s a simple problem of supply and demand. Hospital executives are finding it increasingly more difficult to get physician specialists (e.g., orthopedic surgeons, neurosurgeons, obstetricians, general surgeons and others) to be on call should their services be needed in the emergency room.