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Sunday, April 14, 2024

Recession, swine flu causes crowded emergency rooms

Think you have swine flu? Don’t go to the ER.

The overcrowding of emergency facilities is nothing new to California or the U.S., and amid economic recession and fears of the H1N1 swine flu virus, things have only gotten worse.

“The problem is that people don’t see their primary care doctors for prevention,” said Michael Wilkes, professor of internal medicine at the UC Davis School of Medicine.

Wilkes likens the problem to improper maintenance of cars – people put off regular visits to the doctor like they put off changing the oil in their car to save money, but end up having to pay for costly emergency care in the end.

At Kaiser’s Sacramento Medical Center, officials have reported a 30 percent increase in local patients visiting the emergency room, according to an article in The Sacramento Bee.

Hospitals are overcrowded, not because they’re understaffed, but because the ERs in particular get clogged up with too many people coming in with mild, non-life-threatening conditions such as the flu. Hospital staff and resources must then be used to accommodate these patient needs in addition to those of actual emergency patients likely to arrive in critical condition.

“It’s not that there’s not enough staff,” Wilkes said. “If you have ER doctors taking the place of family doctors, and someone comes in with shortness of breath, the doctor will order an MRI scan which [under] primary care would order the scan and have the patient come back in a few days, but [since] ER doctors won’t get to see the patient again, [those patients have to stay there].”

Dr. Wilkes offered two solutions to this overcrowding.

“One is health care reform and having people not worry about money,” Wilkes said. “The second is having separate ER units – one for actual emergencies, and another staffed with pediatricians and doctors for both primary care and internal medicine.”

Emergency rooms also face an increase in mental health patients, said Carole Gan, a spokesperson for the UC Davis Medical Center. Since Sacramento County has recently closed half of its inpatient beds, in addition to closing its County Crisis Clinic, patients who would have normally visited a mental health center are now turning to the emergency room.

“With no where else to go, patients in the throes of a mental health crisis go to local emergency rooms, including UC Davis,” Gan said. “The problem is UC Davis is not licensed to operate an inpatient mental heath facility and therefore is not equipped or staffed to provide care for these patients in the emergency department.

Although swine flu has been quite prominent in the news lately, Wilkes believes that they should see their primary care doctor but hold off on a visit to the ER unless they absolutely need it. Only severe symptoms such as high fever, inability to keep food down and shortness of breath warrant a visit.

UC Davis graduate Alex Kloehn did exactly this when he scheduled a same day appointment with his primary care physician five days into his encounter with swine flu.

“[Aside from being] given nasal spray and an inhaler to open up my airway,” Kloehn said. “The instructions for getting better were the same as any flu case I’ve had.”

As flu season switches into high gear, Wilkes urges patients to go see their primary care doctor as opposed to the ER.

“If you’re feeling like crap and you have a headache or other symptoms, the [ER] doctors would love to help, but they can’t really do much against the typical flu…” Wilkes said. “They might give you an aspirin, but that’s about it.”

ARNOLD LAU can be reached at campus@theaggie.org.

Correction, Oct. 13, 2009: The original article incorrectly identified Michael Wilkes as the Vice Dean of Medical Education. Wilkes is a professor of internal medicine. 


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