Clearly if you can wait 10 hours for something, it wasn't an actual emergency. Are hospitals just gambling that these people won't die in the waiting room? What's actually going on?
Is there a perverse financial incentive to drag it out?
More notably, more serious problems may require more staff. If the nurses are busy cleaning up bio material, you get to wait a little longer too before you get triaged.
The incentive is not to drag your wait out, so much as to have the minimum staff needed to keep patients stable. Stabilizing people in critical condition is literally the one job of the emergency room.
On the other hand, people go to the ER for all kinds of reasons that are more urgent than urgent care, but less than true emergencies. Sometimes, they even go because they can't be denied admittance for lack of ability to pay, when a general practitioner at regular practice would have been a more appropriate physician to see.
All of that said, a 10 hour wait either means there's an absurdly high number of non-emergencies, or they're facing severe shortages (self inflicted or otherwise).
I refuse to work day ER shifts because along with just a couple motivated RNs, I can often clear all the patients from the waiting room at night that have been there for many hours. Often, we just need a break from new patients and we need to work as a team and just focus on getting one patient out at a time. OTOH, day shifts often make me powerless as a doc just because there are so many other bodies around, each with competing agendas and pressures.
I'm not sure wait time is an informative metric, vs something like survival rate for different kinds of conditions.
Seems to be a good metric for a dysfunctional triage system. How else does a type 1 diabetic with a known non-functioning insulin pump on the verge of going into coma get labelled as non critical.
I’m not defending the hospital in TFA, per se, but my wife recently had an ER visit on a miscarriage. She was immediately admitted and tended to be a doctor for the fact that she was hemorrhaging.
During the course of our 12 hours I came and went from her room through the waiting room and to my vehicle. Saw folks waiting hours and hours. For all I know they had a faulty pump.
When it came time for dismissal, we waited hours and hours. The attending staff were handing a GSW and a head trauma on a child. While I didn’t go full-Karen I had to drop the “my wife suffered a miscarriage and is having a mental breakdown, are we going to be banned from your hostile system if we just leave?” to receive final clearance to leave.
Triage is just… complicated. You can’t plan and staff accurately for random tragedy.
Sometimes things happen that we can't control, but I sure do get tired of ER docs/PAs/NPs overlooking common sense stuff like this. Especially since most good ER RNs would have bugged your provider multiple times to just get y'all the hell out of there!
Also, ER isn't really the place to handle DKA, those patients will cycle quickly through the ER to endocrinology or the ICU. It won't be "give me some insulin manually so I can get on with my day".