When Hospital Crowding Leads to Emergency Department Overcrowding

During the last few years that I worked at OSF-Saint Francis Medical Center in Peoria, I thought that patients were not treated fairly in the Emergency Department. Patients were waiting for hours in the Emergency Department to be admitted to the hospital. We were "boarding" patients and that was dangerous for them.

I talked with Dr. Rick Miller, the Medical Director of the Emergency Department, many times during the 90's about the dysfunction in the Emergency Department. Miller was afraid of OSF-SFMC President and CEO Keith Steffen and did not adequately support the rights of his patients or his staff in the Emergency Department.

Patient and employee satisfaction in the OSF Emergency Department was the worst in the Medical Center in 2001.

The decision was made to relieve Dr. Miller of his duties as ED Medical Director in 2001 and to replace him with Dr. George Hevesy on August 1, 2001.

Dr. Hevesy was director of EMS in the Peoria area for many years and was on the salary of Advanced Medical Transport and OSF-SFMC.

I wrote a letter to Mr. Steffen in September, 2001 and told him of my concerns regarding long and dangerous boarding times in the ED. I cc'd all of my attending partners in the Emergency Department including Drs. Hevesy and Miller.

I was placed on probation the next day by Dr. Hevesy for writing the letter.

In December, 2001 while working a Prompt Care shift at OSF, Dr. Hevesy showed up and told me, while I was seeing patients, that Mr. Steffen wanted me in his office. We walked to Mr. Steffen's office. The OSF lawyer, Mr. Douglass Marshall was present, and I was fired.

What Mr. Steffen put my family through in his office at OSF during the months before he fired me has been documented on Peoria's Medical Mafia. Clearly Mr. Steffen should not be in charge of the largest Catholic hospital in downstate Illinois.

Here is a great article in the New York Times regarding why hospital crowding occurs. And this leads to dangerous ED overcrowding.

I thought this was happening at OSF-SFMC ten years ago.

Here is one paragraph from this article:

The major challenge for any patient in the emergency room is a reimbursement system that offers little incentive to decrease crowding or minimize boarding. Hospitals prefer patients who come in electively for scheduled procedures, at least from a financial perspective. For one thing, they are far more likely to be well insured than those admitted through the emergency room. By boarding E.R. patients in crowded halls, hospitals can offer the required emergency care for all while minimizing the effect on their bottom lines.