Houston ERs Feeling Demographic Stress

(Coughing)

Chekeita Brown showed up at Ben Taub Hospital with a case of pneumonia.

“I couldn’t breathe this morning when I was trying to just walk to the bus stop, I couldn’t breathe.”

Although she works as a home health aide, Brown has no health coverage of her own. What began as an untreated cough and cold escalated over weeks into a far more serious, and costly, condition.

Emergency rooms are the last resort for the uninsured. The Houston region is lagging behind in emergency capacity. For example, the region has only two Level One trauma centers, the ones that provide the highest standard of care. Dan Wolterman is CEO of the Memorial Hermann Healthcare System. He says that’s not enough.

“As Houston has grown so dramatically over the last couple of decades, we have not stayed up with what is a rule of thumb in the industry, and that is for every 1 million people in your population you should have one Level One trauma center. We’re roughly approaching the six million mark in this region, and today we have two.”


The two trauma centers, at Ben Taub Hospital and Memorial Hermann, are right next door to each other in the medical center. UTMB in Galveston used to have a Level One trauma center and it’s working on getting re-certified. But Hurricane Ike and budget woes have forced the hospital to cut back on caring for the poor and uninsured.

DRs in ER
New emergency medicine resident Shane Jenks (on the right) consults with his faculty supervisor in the Ben Taub Emergency Room.

(“Oooh, my leg! Aaah, aah!”)


Doctors and nurses at Ben Taub rush to care for a man who has been shot in the thigh. This summer, the hospital launched a three-year medical residency in emergency medicine. Dr. Bobby Kapur directs the program:

"There is an extreme need for emergency medicine physicians in the state of Texas."

Kapur says that the new program will bring more, and better trained doctors into the Ben Taub ER, and that will help move patients through faster. But Wolterman says ERs can’t handle the problem alone.

“We are very fragmented when we go after the issue of the uninsured and how to care for them. We let each hospital do its own thing with their clinics and with their emergency rooms.”


Wolterman says that without local coordination, the national health reform law will be of little help. He says all the counties around Houston need to pool their resources and create a plan for distributing clinics geographically. In the meantime, people who do have insurance will continue to pay for the uninsured through increased premiums.
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