Time is of the essence. At least according to Shakespeare and of course modern man. Ever been on a slow computer where the connections take more than the usual split second? What about waiting for that Big Mac, when it takes more than a couple minutes? We are accustomed to things happening fast and are peeved when somehow that isn’t the case.

The emergency room visit is a case in point.  Sure, everyone wants to blow in and out of there-I mean who really enjoys the rank smells of various body fluids, drunks lying on guerneys and bearing witness to countless small and large misfortunes? Why can’t a person be evaluated in 20 minutes or so and then either treated or sent home?

Well, the fact remains that dealing with extremely complex systems with a myriad of administrative, legal and medical hurdles is not an easy task. Expect to read about why in the next few blogs.

Let me begin with outlining some of the reasons why it takes so long.

Slapping a couple of beef patties on a grill is not quite the same as evaluating  extremely complex organisms- ie humans.A simple complaint such as belly pain can be caused by benign things such as food poisoning but also by deadly mimics such as an aortic aneurysm. Choosing among an array of tests to determine which is the cause is no simple task. Not everyone should be checked for an aneurysm and some should be, who have only minor complaints.

Tests take time: not only in doing that test, but also in ordering the test, having the proper professional do the study or procedure and interpreting the results. It would be great if each and every health care professional in the hospital were standing around just waiting to do that one test the emergency doctor requested. Reality sucks: there is usually quite a few of these studies to be done-some stat, some urgent and some electively.

Take for example a chest xray. In an ideal world, it should take a minisecond to order, 5 minutes to complete including transporting the patient to radiology and say another minute to view and interpret the film. Throw into the mix about 20 other xray requests, a few for patients critically ill, a hectic, overcrowded emergency room, lack of an immediate transport person, patients having blood drawn or other procedures being performed and you can see how this simple test might take a heck of a lot longer.

Next blog I will continue the rant about why it takes so long.