Amy Kaku (26C) said it “felt like a drill” was going through her head when she walked out of the Emory University Hospital emergency room (ER) after being told it would be two or three hours before a doctor could see her.
“That’s the prevalence of this issue,”Rachel Wang (26C), who is a friend of Kaku, said. “The longer the wait time, the longer someone is suffering.”
Kaku’s experience wasn’t a lone incident. Izzy Hipple (26C) said she waited five hours to get her blood drawn and receive the results at the Children’s Healthcare of Atlanta (CHOA) ER, while Casey Hampton reported waiting a total of 13 hours at two Emory Healthcare hospitals — seven at Emory University Hospital on Clifton Road and four at Emory Saint Joseph’s Hospital.
“If it were an emergency, I mean, I guess the only place I’d have to go is the ER,” Hipple said. “I’ve just kind of dealt with it myself because I feel like it’s not worth it.”
This follows a rise in patient complaints about long ER wait times across Georgia. Additionally, the Georgia Coordinating Center consistently lists Emory hospitals as predominantly “overcrowded” or “severe.”
In an email to the Wheel, Emory Healthcare reported experiencing longer wait times in ERs due to an increase in respiratory illnesses and the closure of Wellstar Atlanta Medical Center on Nov. 1, 2022, which displaced approximately 50,000 ER visits a year across the remaining metro Atlanta hospitals.
“We, like other metro Atlanta health care systems, are seeing higher volumes of patients who need care,” Emory Healthcare wrote.
Emory Healthcare noted that they are working to hire additional staff to assist with larger patient volumes.
“Longer wait times may occur and we ask for your patience and grace as we serve all of those who need medical attention,” Emory Healthcare wrote. “We are here to support our community and those who come to any Emory Healthcare hospital needing care.”
Low resources
Emergency Medicine Specialist Jennifer Steele, who has worked in ERs in the Bronx and Long Island, N.Y. for over 20 years and is not affiliated with Emory, attributed long wait times to overcrowded hospitals.
“When patients do go there, it can just be overwhelming from a provider standpoint, you have so many patients to see that you're just overwhelmed,” Steele said. “Your ability to care for all the patients is impeded, just simply by patient volume.”
Hipple reported seeing a similar situation during her wait at CHOA, noting that the waiting room was “packed.”
“There are only so many doctors and they can only do stuff so fast,” Hipple said. “When there's that many people, I just can't imagine they could do it faster.”
Some students have reported negative experiences at Emory University Student Health Services (EUSHS) that have led them to go to the ER instead. Hipple recalled that a nurse forgot to take her vitals when she sought treatment for a “serious health issue” at EUSHS. She also said that a physician’s assistant mistreated her.
“She was extremely rude,” Hipple said. “She was very short with me. She did not listen to anything I was saying, and she told me that I came in with too many symptoms, and we could only focus on one symptom at a time.”
Hipple did not receive a diagnosis by the end of the appointment, so she turned to the ER instead. She expressed that she has since “avoided” EUSHS and will likely go straight to the ER in the future.
Emory Emergency Medicine Services Emergency Medical Technician Max Walco (25C) said he has witnessed patients being reluctant to seek medical aid due to negative experiences with medical care.
According to Executive Director of Student Health Services Sharon Rabinovitz, EUSHS reviews each complaint about EUSHS and ensures that the student’s needs are addressed in the moment before reviewing processes to ensure that EUSHS optimizes student care.
“We are committed to responding to student feedback, complaints and concerns on an individual basis and have engaged with student groups to gather information,” Rabinovitz wrote in an email to the Wheel. “We are developing a Student Health Advisory Committee to ensure we have intentional and sustained student voices shaping services and access.”
Rabinovitz encouraged students to contact her regarding any issues with EUSHS, noting that she is not currently aware of any outstanding student concerns. She added that Emory created the associate vice president for health, well-being, access and prevention position last year to further enhance their response to heath issues and prevention.
“We recommend students make a physical appointment or other preventive care appointments such as pap smears, STI testing or contraceptive appointments to ensure proactive support, education and management to prevent illnesses,” Rabinovitz wrote. “Early mental health support is equally as important at the early signs of impact, i.e., sadness lasting longer than previously, losing interest in activities which you previously enjoyed, difficulty concentrating.”
Long wait times are not unique to Emory. Patients with non-emergent cases will experience prolonged waits, particularly during influxes, according to Steele.
“Wait times get longer and longer because we are taking care of the high acuity patients first,” Steele said. “You don't tend to come in and out of the ER. A lot has to be done.”
Steele recommended patients go to an urgent care center or similar facilities for issues such as sore throats, colds and fractures.
Grady Memorial Hospital Hospitalist Elizabeth Marshall-Smith, who has worked in hospital medicine since 2013 and joined Grady in May 2022, recalled seeing many patients come through the Grady ER to receive dialysis, which is located in another part of the hospital. They took up social resources that could have been better allocated elsewhere, such as receptionists who were delayed in intaking ER patients while checking in and guiding dialysis patients, Marshall-Smith said.
Patients’ wait time extends beyond the waiting room, according to Marshall-Smith. She has witnessed patients waiting as long as 48 hours in the ER after initial intake because there were no available beds on the floor.
Marshall-Smith added that short-term bed and observation areas at Grady would benefit patients who do not need to stay in the hospital longer than 48 hours, but still require more than a couple hours of care. Moving a patient into this unit would open up a bed and provider in the ER.
Although hospitals would benefit from hiring more physicians, Marshall-Smith stated that the real issue is that hospitals lack the resources to move patients to beds in appropriate units of the hospital, so they are stuck waiting in the ER.
Economic issues
Another prominent factor in ER wait times is that patients “simply don't have the money” to afford primary care, according to Marshall-Smith. According to the Commonwealth Fund, 15.7% of Georgia adults reported receiving no medical care due to cost. For every 100,000 deaths in Georgia, 106 result from a lack of health care.
Marshall-Smith explained that not receiving primary care causes people’s medical issues to escalate and ultimately requires more hospital resources.
The average salary in Georgia is $18.75 per hour, according to a survey of 1124 salaries. If someone works eight hours per day for $18.75 per hour, a day trip to the ER would prevent them from making $150. However, the average cost of an ER visit is $1,589 for uninsured Georgians. This cost equates to what a person would earn if worked eight hours per day at $18.759 per hour for over 10 working days.
Steele added that some areas, like Queens and the Bronx, have a skewed patient-to-doctor ratio, meaning people do not have access to primary care, even if they can afford it.
“Primary care and preventive medicine is the best way to go,” Steele said. “We literally need more doctors, more providers in these very underserved areas.”
She added that doctors also tend to congregate in highly populated urban settings.
“There are also a lot of physicians that prefer to highly specialize,” Steele said. “If that's your passion, you do need to be in an urban setting because you're not going to have a patient population that you can serve in these smaller areas.”
Steele attributed “inappropriately expensive” medical care prices to poor allocation of resources — such as nurses, beds, additional hospital wings and X-ray machines — not corruption.
According to Marshall-Smith, the big difference between Grady and the other hospitals she has worked at is the funding. She stated that while hospitals were not ”rolling in dough,” a greater number of the patients at these hospitals were insured compared to Grady.
If a patient is insured, their payment to the hospital is guaranteed. However, uninsured patients — which make up 18% of Georgia adults — “may or may not pay,” according to Marshall-Smith. Since the care has already been delivered, a lot of care provided by Grady is not being reimbursed.
“The emergency room isn't a moneymaker,” Steele said. “It tends to be a place that is expected to and is required to catch and read all, and because of that, there's a lot of patients who have no insurance, there's failure to pay, and it probably usually operates in the red. So, of course that's going to influence an administrator’s decision when they're allocating funding.”
Marshall-Smith added that Medicare expansion would benefit patients.
“As frustrating as those deficits are to deal with, I think they're doing a pretty good job with what they have to try to limit those deficits and try to give the best care and the best option that we have,” Marshall-Smith said.
