Our hospital systems are broken
On September 20, Mike Herrera checked into the waiting room at Parkland Memorial Hospital in Dallas, Texas (the same hospital that Kennedy was brought to when he was shot). He was complaining of a stabbing sensation in his abdomen. The man collapsed 19 hours after he first checked in. Medical staff rushed to help Herrera but it was too late. He died.
As a physician, let me say that my heart goes out to Mr. Herrera’s family and friends. It should never happen. There is simply no adequate excuse.
Having trained at Parkland Hospital, I can say without a doubt that the staff is as caring and knowledgeable as any in the United States. The problem here is resources. Parkland has one of the busiest emergency rooms in the country. There is nowhere to put all of the patients. Every treatment room is full. There are stretchers with patients on them in the hallways of the ER. Doctors and nurses and physician assistants are seeing patients as fast as they can. To make matters worse, the rest of the hospital is usually full, too. Therefore, it is possible to admit a patient to the ER and for that patient to remain in the ER for several hours to several days because there is no bed availability in the rest of the hospital. This is of little consolation to the Herrera family but it is a fact. In my opinion, any patient that has waited more than 2 hours has waited too long.
The problem with indigent care in Dallas, Houston, Miami, Atlanta, Los Angeles, Chicago, New York and many other major cities is that it is overwhelming. We can point fingers at the large immigrant population. We can blame the economy. We can blame a healthcare system that has decreased reimbursement to hospitals every year for the past 15-20 years so it is much more difficult to expand when there is very little money for expansion.
Parkland Memorial Hospital is a county hospital. Although it has expanded over the last 20 years, it has not kept pace with the population of Dallas County. This is a problem that no one really wants to address. If you’re a city councilman, where would you spend the city’s money? You can build satellite hospitals in the poor areas of Dallas or you could build parks and paved roads in the rich areas of Dallas. Granted, my analogy is not entirely fair but it isn’t entirely wrong either. There is little political will to pour hundreds of millions of dollars into a hospital that takes care of poor people.
This is a serious problem with the national discussion on health care. No one is talking about building more hospitals. We need more doctors and we need tens of thousands more nurses. We need more respiratory therapists and occupational therapists. We need more healthcare personnel. How do we do this? Where is the money going to come from? This is something that we need to be talking about so that we never again hear about a patient who is was in the ER for 19 hours.
