[BigRedBeta]

Most academic medical centers I'm aware of are completing huge expansions of their ER's, but despite this growth, the ER's are still swamped.

The most important thing is that it takes time to give medical care. Lab tests have to be run, CT scans and X-rays have to be taken and so on.

If people are sick enough to be admitted to the hospital then the ER docs have to wait for the physicians from the team that's going to be the primary care givers to come down from whatever they're doing to complete the admission. Meanwhile a bed has to be found, there's a ton of paperwork to be done, and so even those patients who have had decisions made on their care sit in an ER room for a long time. There have been plenty of times when I've been on the wards and my team has been told we're getting an admission and it's 3+ hours before they actually make it to the floor and into a room.

Throw in the occasional serious event (trauma, patient with chest pain who's crashing) that causes everyone to drop what they're doing, and the flow of things get even more disrupted.

Lastly, if you're in the ER towards the end of a shift change, it's going to be even longer as there has to be handoff of patients that are currently in the process of getting care. Check out takes time and is a well documented point in which medical errors occur, so there is an emphasis, particularly in the ER about getting it right.

Certainly, nothing I've said makes it any less frustrating when you're waiting for hours, but it's important to state that the ER is not a joke to doctors and nurses.

If you have to go to the ER for care, it's best to go as early in the morning as you can. Most places I've been have a pretty typical "schedule" where there are very few patients in the morning and things just get busier and busier as the day goes on.