Walk-in patients will, of course, continue to arrive. A full emergency department usually means that the inpatient service is full, and that nurses, doctors, clerks, and housekeepers on the hospital floors and in intensive care units are likely to be flat out. The last thing they feel like doing is coming up with a bed for a patient awaiting admission from the emergency department. A full emergency department usually also means a waiting room full of walk-in patients and a waiting time of three or four hours. Although walk-in patients are triaged before their wait begins, their condition may worsen while they wait, and the results may be disastrous.
Some patients give up and leave.
Contrary to popular myth, it's not just those with minor problems who leave, but sometimes patients with life-threatening illnesses, too. The diversion of ambulances from Boston's emergency departments is a chronic problem, now getting worse. Once only a winter phenomenon reflecting the increased demands of flu season, ambulance diversion has become a year-round problem. Bed and worker shortages, limited access to clinics and providers, and gaps in insurance coverage all create problems that eventually end up in emergency departments. Massachusetts is the only state where Medicare, Medicaid, and private insurance pay less than cost.