Emergency rooms across Ohio are facing a boarding crisis, with patients waiting hours for a hospital bed to open up, and a recent analysis suggests things may get worse following an anticipated multibillion-dollar loss in the state's health care system, as reported by News 5 Cleveland. This series of extended wait times has been linked to increased rates of mortality, and the situation appears particularly dire for marginalized patient populations.
According to the Ohio Capital Journal, a study by Health Affairs found that before the Medicaid cuts were implemented boarding times in the emergency department (ED) had already seen a significant rise, reaching a peak in January 2022 during the COVID-19 pandemic, but remaining elevated above pre-pandemic levels, boarding beyond four hours has become increasingly common with incidents spanning over 24 hours becoming more frequent and the president of the Ohio Chapter of the American College of Emergency Physicians, Christina Campana, warned that once the One Big Beautiful Bill Act's cuts to Medicaid spending take effect, the reductions in staff will prolong patient wait times, potentially exacerbating health outcomes for those awaiting care.
Meanwhile, in the realm of rural health care, experts have raised concerns over the growing trend of emergency rooms operating without doctors present, a situation highlighted by a News from the States report that disclosed the challenges faced by small hospitals, such as Dahl Memorial's three-bed emergency department in Montana, which relies on physician assistants and nurse practitioners due to a nationwide shortage of doctors.
The survey, led by Harvard Medical School's Carlos Camargo, found that at least 7.4% of U.S. emergency departments did not have an attending physician on-site 24/7 in 2022, largely in low-volume or critical access hospitals; however, certain medical associations like the American Medical Association (AMA) and the American College of Emergency Physicians (ACEP) are pushing for regulations that would mandate ERs to staff a doctor around the clock, although healthcare organizations argue that experienced advanced-practice providers can effectively oversee ERs and that enforcing such mandates could risk closing rural hospitals that are already struggling to afford or recruit doctors.
While the proportion of ERs without a constant physician present differs by state, ACEP President Alison Haddock told the News from the States that "it's important that folks in those areas have equal access to high-quality emergency care to the greatest extent possible," and despite the challenges, hospitals like Dahl Memorial ensure providers have extensive emergency experience and the capability to consult remote physicians, to maintain the level of care in rural settings where the availability of experienced medical staff remains a critical issue.
