Emergency rooms in the United States often experience crowded conditions and long wait times. The National Center for Health Statistics found that the average wait time in emergency departments grew from 38 minutes in 1997 to 56 minutes in 2006. Many people go to the emergency room for conditions that do not need urgent care, which can use up resources meant for more serious cases.<\/p>\n
To address these problems, some hospitals, like Memorial Hermann Memorial City Medical Center in Houston, started early triage programs such as the “quick look” strategy. In this program, nurses or senior doctors quickly assess patients within five minutes of arrival. At Memorial City, this strategy cut the wait time to see a doctor from 93 minutes down to 20 minutes in just a few months. It also reduced the number of patients leaving without being seen from 10% to 2%, showing better patient handling and satisfaction.<\/p>\n
Another method, called Senior Doctor Triage (SDT), has been used in England and is relevant in the U.S. In SDT, senior doctors lead the first patient assessments. Having experienced doctors involved early helps start tests and treatments sooner, which speeds up patient care. This process improves safety and helps control how patients move through the emergency room. It also allows doctors to decide earlier if a patient should be admitted, transferred, or safely released.<\/p>\n
Even though early physician involvement has clear health benefits, it also brings significant costs. Hiring senior doctors for triage increases staff expenses because doctors earn more than nurses or physician assistants. Also, the short time doctors spend on triage may not always be paid for by insurance, which creates financial challenges.<\/p>\n
Dr. Art Kellerman, a professor at Emory University, pointed out that hospitals face cost problems when using physician-led triage. While it makes patient care faster and safer, keeping these programs going is hard when hospitals do not get enough reimbursement. Some hospitals with tight budgets have gone back to nurse-led triage or cut back the time doctors spend in triage, even if this lowers patient flow and satisfaction.<\/p>\n
There are other financial issues hospitals must consider:<\/p>\n
Medical practice leaders and IT managers should understand these financial details before adding or expanding physician-led triage in emergency services. They need to look closely at budgets, staffing, and reimbursement rules.<\/p>\n
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