‘Emergency rooms are not Lulu or Carrefour’: doctors warn about timewasting at trauma units



DUBAI // Hospital emergency rooms are buckling under the pressure of unnecessary visits by patients with minor ailments seeking a one-stop shop.

“Like Carrefour or Lulu,” said Dr Firas Al Najjar, head of emergency medicine at Rashid Hospital in Dubai. “It is very important to recognise the tremendous overuse and misuse of emergency departments. We need to start thinking how we will change the system.”

Doctors complain of emergency rooms full of patients with complaints such as headaches, flu and muscular pains, who should instead have visited a GP.

“What people have to know is that if they have a non-emergency case and come to the ER, they may take the bed – or the life, even – of a very sick patient,” said Dr Mahmood Ghanaim, head of the emergency department at Dubai Hospital.

Emergency departments are intended only for those in a life-threatening or critical condition, he said. “But now it is easy to come to the emergency department.

“They want to be served fast. And when you come to the ER you are served fast. And you feel that atmosphere of security. But 50 per cent of the cases could be dealt with in primary care centres.”

Dr Ghanaim said changing this mindset would not happen overnight. “We can do it gradually by teaching our customers and our clients who come to the ER, to explain who is in need of an emergency doctor.”

“The role of the emergency physician is not only acute care but also education. It is extremely important to change the mentality,” Dr Ghanaim said.

However, the call has prompted concern that fewer emergency visits may result in budget cuts and reduced staff.

Dr Al Najjar said the issue was complicated by a potential loss of business at hospitals that eliminated time-wasters. “The administration will ask, ‘Why did we lose these patients?’ They need the numbers. This is a problem.”

It could result in staff reductions and budget cuts, he said.

However, Dr Al Najjar agreed many hospital visits were avoidable, and described emergency rooms as a “one-stop shop”.

“The other problem – some will not understand the need to wait because the condition is not serious,” he said.

“Every patient has the right to be seen but they should understand there is a need that we are taking care of the serious patients first.

“We need proper education. What we can do is whenever we are finishing with the patient we are educating them that whenever you have this condition in the future go to this centre or to this physician.”

More 24-hour clinics and ambulance centres would also ease the burden, said Dr Najjar.

Dr Ayesha Al Memari, a consultant in emergency medicine and critical care at Mafraq Hospital and general secretary of the Emirates Society of Emergency Medicine in Abu Dhabi, said misuse of emergency departments was widespread and had a knock on effect.

“The main thing is overcrowding. People wait longer to be seen. So somebody who really needs to be seen will be pushed back by somebody who is non-urgent.

“It is really, really important to educate people about emergency department abuse and misuse and what other health channels they can approach.”

jbell@thenational.ae

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