08 March 2011

Annals of Crappy Journalism, part XXVII

So I saw the headline in my inbox today as part of my daily "news" update from ACEP:

and I thought to myself, "what in hell is going on in California?" I mean, I know it's all locusts and rivers running red with blood what with the budget crisis and the balance billing law and the mandatory nursing ratios, but I thought someone for sure would have told me that 20% of their patients were now walking out of the ER without being seen. I mean, I know people who work in California, and none of them have mentioned that they are living in a post-apocalyptic end time. So I clicked through to the article linked, a place called "Healthday.com":

Fortunately, there was a citation, of sorts, to the current article published in the Annals of Emergency Medicine (subscription required). I eagerly clicked over and read the following:

We studied 9.2 million ED visits to 262 hospitals in California. The percentage of left without being seen varied greatly over hospitals, ranging from 0% to 20.3%, with a median percentage of 2.6%.

So... median 2.6%? That's, uh, not too bad. We do better. Yay us? But it's not 20% either. So what's the deal with the breathless headlines? Oh, I see, 20% was the max, at ONE hospital. Yeah, that's pretty bad. But it doesn't quite jibe with the breathless headlines implying the problem is state-wide, does it?

So, it's a decent article, better than the dreck they often publish as "research," but I can summarize it fairly easily: blah blah blah, poor people at underfunded hospitals get shitty service, notify the press! It's completely unsurprising, an example of the category of EM literature I refer to as "proving the intuituvely obvious." There is an interesting corollary that they did not comment on -- that funded patients are much more likely to leave without being seen than uninsured/medicaid patients. This is in part because funded patients have higher expectations of customer service, and in part because funded patients are more likely to have other avenues to access care (i.e. a primary care doctor or specialist). But I digress. Yes, it's an important article because it does quantify the existing problem. But healthday's writer (or, more precisely their editor who wrote the headline) completely failed to understand the statistics and now this inaccurate statistic is being spread all over. And I'm annoyed.

Yeah, I know, I'm about six weeks away from yelling at the kids to get the hell off of my lawn.


  1. The reporting was misleading but I think the picture of the situation in CA probably was too. I live in a small city with a population of approx. 125,000, my next door neighbor is a just retired ER dr. and thinks that the 20% being reported is pretty accurate for this area. I've had medical insurance my whole life, as has my entire family and I can tell you that living in the SF bay area causes one to have an extremely negative view of emergency rooms and the service that is being provided in our area. I would have to be convinced my situation was really life threatening before I'd endure the situation.... and if you only speak English you may need a translator to understand the broken English of many of the nurses who speak Tagalog to each other in your presence.

  2. CA isn't the only area filled with new imports from that country hired sight unseen, pushing our own nurses out.

  3. Yeesh. How rude to speak a language. In your presence. Assholes.

  4. Go ahead and yell at 'em. Makes ya feel better.


  5. That's typical of almost any medical headline you read in lay newspapers - they report it in such a way to make it grab you. Even if it is misleading.

  6. Wow, Jeannine, I'm sorry you feel that way but that has definitely not been my experience of bay area emergency rooms. I've been a patient in three (non-life-threatening sports injuries, mostly) and a volunteer in a fourth, and none of them has impressed me as being particularly bad. Likewise I've met quite a few Filipino ER nurses and all of them conducted their activities in English. If anything we could use more diversity in ERs to better help the many patients who speak Spanish, Chinese, Persian, various south Asian languages, etc.

  7. There's an additional consideration here that isn't really talked about by the headline. Probably 20-40% of ER visits are unnecessary. I've seen mom's come into the ER wanting their kids seen for a stomach ache, fever, or sore throat. After waiting 4 hours or so, they leave and come back the next day or later.


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