Report: Influential patients move to the front of the pack in ERs

Kevin Lyons

Imagine this: You’re in the emergency room waiting for a doctor to come check on the ankle you severely sprained playing flag football with the guys. You’ve been waiting for two hours, but it’s OK, you figure, because the medical professionals must be tending to people in much more dire straits than you’re in.

How would you feel, then, if you found out you waited so long because the ER doctors immediately admitted someone with a lot more influence than you’ve got?

If you’re not a VIP, you may be in for a longer wait at an emergency room.

It happens all the time, according to a letter published in a recent Annals of Emergency Medicine and a nationwide study conducted by Truth on Call for MSNBC.

More than half of the 33 emergency rooms in Connecticut provide “expedited” care to influential patients, according to MSNBC, citing the Annals of Emergency Medicine study. Furthermore, 84 of 100 ER doctors nationwide have given or would give special attention to an influential patient, such as a famous person or a hospital donor, according to the Truth on Call study done for MSNBC.

Typically, ERs operate on a first-come, first-served basis, with the sickest people being put at the front of the line. But as the two studies mentioned, high-profile patients always are taken care of, sometimes ahead of people who’ve been in an ER much longer than they have.

Dr. A.J. Smally of Hartford Hospital and the University of Connecticut, who published the letter in the Annals of Emergency Medicine, upholds the practice of pushing high-profile patients to the front of the line in ERs.

“Somebody calls and says, ‘So-and-so is coming in, can you make sure they get good care,’” Smally told MSNBC. “We bump them up a notch. If everyone is waiting four hours, they might just wait one hour.”

Bill McGinly, president and CEO of the Association for Healthcare Philanthropy, also defends the practice, telling MSNBC that his members pay special attention to their donors. “They’ve gone above and beyond,” McGinly says of the donors. “We recognize that their contributions can make a difference to the community.”

Of course, MSNBC’s study points out that this philosophy does have its detractors.

“It’s not fair at the micro-level, and I’m not sure it’s fair at the macro-level,” says Laura Weil, former director of the Health Advocacy Program at Sarah Lawrence College in Bronxville, N.Y. “You can be in pain, or just feeling horrible, and see person after person be treated ahead of you.”