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Thursday, July 15, 2010

The other Emergency Room issue

A dwindling pool of emergency room doctors and medical personnel has helped increase waiting room times in hospitals across the Garden State.  And as more doctors decide to practice outside of New Jersey, the average wait time probably won’t improve anytime soon.  It affects all of us: whether it’s a broken bone, a fainting spell, lack of insurance, or accompanying a friend or family member, most of us will spend time in the ER.  If your emergency can wait for any length of time, usually it does.  Understandable when there are patients who are in more emergent situations. 

So when I read Jennifer Golson’s story in the Star-Ledger about a female Muslim patient languishing in the emergency room for five hours, I couldn’t help but wonder if there is a latent issue spanning all races and creeds.  The patient, Rona Mohammedi, is suing Somerset Medical Center for religious discrimination and violating New Jersey’s version of the Patient’s Bill of Rights. 

Sporting a hijab, Ms. Mohammedi went to the emergency room last February with severe chest pain.  An electrocardiogram was ordered, and in a nod to her religious convictions, she asked for a female to conduct the test. 

The important question is why Ms. Mohammedi was waiting.  It was likely either because (A) the hospital staff was deliberately hostile toward her request, or (B) there wasn’t a female available to perform the test. Was she being ignored, or did she merely become tired of waiting?

It ended when her husband requested a transfer.  A lawyer for the hospital said that Ms. Mohammedi was informed of her options and left against medical advice.  Michael F. Schaff, chair of the health care department at Wilentz, Goldman, & Spitzer said that the Patient’s Bill of Rights makes no mention of lawsuits, and that “there is no obligation to require hospitals to have a physician on staff 24 hours a day, seven days a week based on their sex, religion, or nationality.”  That’s particularly crucial in New Jersey, since our shrinking pool of doctors makes it increasingly harder to find physicians, much less filter physicians based on sex, religion, or nationality. 

The New Jersey Hospital Association (NJHA) said that hospitals are required to make “reasonable accommodation” for patients with special requests, but how “reasonable accommodation” is defined can vary, said Kerry McKean Kelly, their spokesperson.  “Especially in a high intensity place like the ER, the question of what is reasonable can vary hour by hour based on factors like the number of patients in the ER, the severity of their conditions, staffing levels, and in this case, the gender and credentials of various staff members.  A hospital’s first responsibility is to stabilize their patients and then prioritize…” 

For a multitude of reasons, we all spend too much time in the ER.  Some contributors, like the doctor shortage, are underscored in New Jersey.  Other reasons – like a large number of uninsured residents per capita – are not unique to the Garden State. Additional preconditions placed upon our emergency rooms can turn a very long (but ordinary) ER visit into grounds for an attractive lawsuit if the patient is able to wait for their accommodations to be made but gets frustrated with how long it takes. 

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