Emergency Room availability

personally I used Lenox Hill a few times and was not happy.I was very pleased with NYC, also when I took my mom once to Bellevue.
For kids-seen promptly at NYU,but they lack a pediatric attending at night,so came with the baby home at 10 am from NYU,back at 11 am at Cornell-different diagnosis and more complete treatment.From personal experience-NYU for adults,Cornell for children.

On the west side, Roosevelt's on 59th is fine for adults - unless you're talking about cardiac type emergencies. For kids, St. Luke's at 114th is the closest but I hated the pediatric ward (my kid was admitted from ER, didn't wait at all though ...) Ward was filthy, nurses hardly came by, and I was more petrified of kid getting sicker in there than not getting better. Kid shouldn't have been hospitalized at all (they were probably thrilled to get an insured patient).

I have switched to a non-insurance taking pediatrician - they have fantastic after hours service and they usually transfer patients to Columbia on 168th. So instead of going to the ER, we tend to call the ped now. Downside - $$$. Insurance reimburses a mere fraction, so we end up about 2k annually out of pocket for the kids (that's with no serious illnesses). And this isn't going to change with a nationalized scheme either. Bottom line: good docs are all going out of the system.

The other factor is if you are going to be admitted right away, and that's kind of a Catch-22 problem if you don't know what is wrong with you.

I'm on the west side and the better hospitals are on the east side.

wow, thanks so much guys for the details...

last time (and only time) we went through this failed emergency visit i swear to myself to do the research to prevent another crowded emergency room episode. but procrastinated for a year till i hear St Vincent's story. thanks again!

nyc10023, regarding "St. Luke's at 114th is the closest but I hated the pediatric ward (my kid was admitted from ER, didn't wait at all though ...) "

did you visit during the day? we did it at night, and ask them what was going on. they told me it's like that every single night and that they would like to turn them away if they could (???). and i thought the same thing as you did. with all the sick people in a confined place for hours, i was probably making my baby sicker by staying there.

"Bottom line: good docs are all going out of the system." that's familiar to me, all my life my parents used doctors without insurance, paying out of pocket. they paid regular insurance just in case (only for catastrophic events) but always felt that the best doctors were out of the system.

"unless you're talking about cardiac type emergencies."

yes! i wanted to have that covered, any suggestions? (hubby has hypertension and mother in law that visits already had a stroke). any suggestions for that?

if it's a real emergency, ambulance will take you to the closest ER(can't choose)or the nearest stroke center,you might not have a choice there.

There was an NYT article on this. Suggests that Tisch is a good option and this article suggests that you CAN choose.

http://query.nytimes.com/gst/fullpage.html?res=980DE3DC1F30F935A25756C0A9639C8B63&sec=health&spon=&&scp=10&sq=emergency%20room%20cardiac%20best%20hospital&st=cse

We went to the pediatric ER at St. Luke's at night. I have no memory of lines or crowds. But it was obvious that we were insured patients, and clearly wouldn't make an ER visit for no reason. I hate to say it, but ER doctors TOTALLY discriminate (maybe wisely given time & $ concerns) based on how you present yourself. Someone who comes across as well-educated, articulate, there for a reason, usually gets taken very seriously even if the symptoms aren't bad. I can't otherwise explain the excellent and prompt treatment.

I would do Columbia Presbyterian next time, because of the ped's relationship with them for my kids. Maybe Mt. Sinai or Weill Cornell if we were closer. The private pediatrician is worth every penny, IMO.

"if it's a real emergency, ambulance will take you to the closest ER(can't choose)or the nearest stroke center,you might not have a choice there."

wow, i hope that is not the case for those of us close to St Luke!!!

"We went to the pediatric ER at St. Luke's at night. I have no memory of lines or crowds. But it was obvious that we were insured patients, and clearly wouldn't make an ER visit for no reason. I hate to say it, but ER doctors TOTALLY discriminate (maybe wisely given time & $ concerns) based on how you present yourself. Someone who comes across as well-educated, articulate, there for a reason, usually gets taken very seriously even if the symptoms aren't bad. I can't otherwise explain the excellent and prompt treatment."

nyc10023, we are obviously talking about different places given that everybody i talked to that went there had the same experience as i had.

"if it's a real emergency, ambulance will take you to the closest ER(can't choose)"

True.

But on the flip side, there's no waiting. Ambulance patients are immediately admitted into the emergency room.

Matt, we went to St Luke in an ambulance with the insurance card on hand...

really, if you didn't see more than a hundred people waiting forever in the ER, you weren't at St Luke. nurses said it was like that always. seems like a dead sentence to me, want to avoid it at all cost the next time.

anyway, i remember the NYT article, read it when it was published. that was 5 years ago! it's a great article, but from then on the article structure of a thesis with 3 "cherry picked" cases and their pictures to prove the point seemed to me like a pattern of the NYT. what a nerdy point of view! LOL

it was the very 1st time i've read about poor people waiting for their turn on affordable housing waiting lists.

you can't choose, but it's not necessarily the closest hospital, it's a combination of factors. and you won't necessarily be admitted right away. you'll go through triage as soon as the next triage nurse is available, but there may be other ambulance arrivals before you.

if you are ambulatory and not at risk of sudden death, you are better off taking a taxi to one of the better hospitals. although there you may have a nasty wait as well.

i've had some wicked long wait times at very good hospitals, even with rather extreme conditions. and we have insurance and present just fine.

AR, look in the article, both 1st cases were given 2 options each while in the ambulance.

granted, the article is from 2005, it could have changed since then?

Unbelievable but true story:

After my move, I was up and down on a chair, putting dishes into my new kitchen cabinets. One of my kitties, still disoriented from the move, was at my feet the whole time. Stepping backwards off the chair, I *started* to step right on him (I didn't, because I was being careful and I knew he was close by somewhere). Since he was backed into a corner, he freaked out, panicked, and bit my leg.

It was a warm Thursday night, around 9:30 PM. I took myself to the ER at Roosevelt, and I kid you not ... there was NO ONE there! No one in the waiting room! They took me right in ... and inside the ER ... NO ONE! The doctors and nurses were literally just standing around, chatting, like bored sales clerks at Bergdorf's on a Monday morning.

I got an X-ray, exam, and tetanus shot, and was out the door within 20 minutes.

Very weird. But quite nice!

matt, your story seemed unbelievable to me ... till i realized it wasn't St Luke you were talking about.

our visit was during winter, a Wednesday night... it was so crowded some people were sitting on the floor. we were given a room right away, and then we waited for the doctor... for hours. while even the hallway was full of people till a nurse showed up to explain what was going on.

i delivered my son at roosevelt, had the best experience. the nurses were amazing (though the place wasn't very clean).

notadmin, a key part of ER is triage. When you say you waited forever to be seen, do you mean that they didn't ask what the problem was as soon as you showed up? Not likely.

Otherwise, they provided good service ... they gave priority to those who showed up, and kept moving those who were non-emergent down the list.

It's unfortunate that poor people have a greater incidence of chronic health problems, but again those who were non-emergent that particular night sat around "forever", and those who had more immediate emergencies didn't. It's also unfortunate that very poor people tend to be not much to look at, and their behavior can sometimes seem unpleasant, and maybe that the waiting area was shabby and littered ... but ER rooms aren't spas, and hospitals aren't resorts.

I hope (for all) the aesthetic problems and scheduling problems are infrequent enough that in the end that's not a big deal, and good actual medical treatment is. I wouldn't pick an emergency room on those bases.

And whatever happened to Doctor's Hospital? It would thrive in this New Gilded Age. Not sure they had an ER, though; probably not.

my daughter was taken to the ER in an ambulance a few years ago. we were not given a choice, and were told we had no choice (middle of the night, we wanted NYU and got Beth Isreal). our doctor told us we wouldn't necessarily have a choice, but to make a polite request for NYU (DENIED!).

my guess is that in these specific cases either option was equally available.

well alan, i did procrastinate on finding out what to do in an emergency (lucky me, nothing happened). but i was advised by nurses at St Luke literally to avoid it as it doesn't function as an ER due to overflow... so sorry, i feel like taking their advise instead of yours as they know what's going on (and really, they seemed overwhelmed too).

i did have a better ER experience in the middle of nowhere in one of the cheapest areas of the country. so i do feel like it's not so much to demand to have a proper ER. i don't feel i'm behaving like paris hilton to receive a moralistic statement regarding discriminating the poor and the like.

btw alan, i do get it that if everybody that pays runs away from St Luke, then their budgetary problem gets worse just like at St Vincent's. but hey, even their nurses advise to do that. the ER issue has to be solved at a higher level, maybe nationalized health care, which i support.

"i don't feel i'm behaving like paris hilton to receive a moralistic statement regarding discriminating the poor and the like."

Oh, let Alan have his fun.

It's his forte.

ok matt, just cause you ask.

"the ER issue has to be solved at a higher level, maybe nationalized health care, which i support" ... yes, that is an important part of the solution. Then people who need routine care can schedule appointments and (for several reasons) stay out of the ERs.

"better ER experience in the middle of nowhere in one of the cheapest areas of the country" ... a big problem nationwide is a glut of hospital beds, and not enough business to support them. I'm not sure if this is equally true of ERs, but probably.

"i don't feel i'm behaving like paris hilton" ... I don't think you are, either; more like London Tipton. She's funner.

> "i don't feel i'm behaving like paris hilton" ... I don't think you are, either; more like London Tipton. She's funner.

thanks alan, i don't know who london tipton is though. my gut feeling is that it's maybe better that way.

Your gut feeling is spot on.

She's a Disney TV character (of course!):
http://en.wikipedia.org/wiki/London_Tipton

alan, don't take this the wrong way, how old are you?

AH: not so quick to say nationalized HC the answer to packed ERs. ERs are packed in Canada, AD & Ds packed in the U.K. Being able to make an appt with doc <> to actually being able to wait for one. And in Canada and I think the UK, kids don't get peds unless they've been seriously ill.

Notadmin: I tell you, we were there Oct '06 St. Luke's pas probleme. I don't want to get into the specifics of the kid's situation but there was zero wait. No one told us to avoid anything. Maybe things have changed in 3 years.

He's 41, going on Driving Miss Daisy.

I'm of a certain age.

What I've heard about the UK, at least for London (the city, not the Disney character), is that if you're a bit sick, you don't want to see NH doctors, you'd go private if possible; but if you're very sick, you definitely want NH hospitals, never private. I don't know exactly why, but I do wonder long ER waits there are more a function of deteriorating health caused by delayed Dr. appt.; or of the convenience of a drop-in boutique attitude ... ?

"I'm of a certain age."

See, notadmin?

All those old ladies don't like to admit their age.

thanks matt for bringing light to this issue (alan's age). given the disney thing and how quickly he goes into moralistic stuff... i thought early 20 at the most. my bad.

"thanks matt for bringing light to this issue (alan's age). given the disney thing and how quickly he goes into moralistic stuff... i thought early 20 at the most. "

LOLOL ... no no, girlfriend's been around the block quite a few times.

I just look early 20 at the most. Has it occurred to you to ask if I was involved in the production of that TV show?

alan, my gut feeling told me that could have been offensive to you.

nyc10023,I have not read the article you posted a link to(maybe I find some time later),but I am a physician and I worked in a NYC hospital and in a few NYC clinics,too.My point is, if you call an ambulance and the EMT personnel feels you are in a critical condition and you might destabilize,they will take you to the closest hospital.They cannot afford to transport a deteriorating patient in an ambulance halfway through the city(due to liability,limited training etc.).My point is, in a REAL emergency, closest hospital might be the only choice,and yes,you get priority and no waiting in that case because EMS communicates right away with the ER.Otherwise, as I said before,my preference is NYU for adults and
Cornell for children, but I live downtown.

Apparently there's no limit to how far they will go, and how many other hospitals you pass, to get to the ER of your choice. I recently stayed in Lenox Hill's ER overnight (good service, unluxurious bed linens), and the guest a few beds down came, along with her kidney stones that were bothering her not for the first time, from Monroe NY by ambulance.

$$$$$$$$$$$$$$$$$$$$$$$$$!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

only: I guess there's critical and critical. Chest pain <> critical, I suppose.

I've been taken to the ER once in an ambulance, non critical, and I had a choice.

Maybe try going to an urgent care clinic instead? There are also doctors in a few Duane Reade Pharmacies in the city during the day, although when I went (34th and 3rd ave), doc and nurse were surfing the internet...