When Dr. Trey Dobson started practicing emergency medicine in Vermont 20 years ago, he might arrive in the morning to see one patient who came in overnight still waiting to be discharged to a skilled nursing facility or rehab center.
Now, there are often five to eight patients in the emergency department each morning, waiting for a place to go.
“That's a third to a half of our emergency department,” Dobson said. He’s the chief medical officer at Southwestern Vermont Medical Center in Bennington, and he also works at the emergency department at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire.
“These patients, they might have been waiting 24 hours or 48 hours,” he said. “And you can’t bring them into the hospital because they don’t meet the regulatory requirements for inpatient hospitalization.”
The problem of not having an appropriate place to discharge patients who aren’t sick enough to be in the hospital but aren’t well enough to go home on their own is creating a backlog in emergency rooms across the region.
“Every hospital in the state is caring for patients who could move to another setting if it were available,” several emergency medicine doctors wrote in a recent op-ed in VTDigger. That’s as dozens of residential care facilities in the state have closed in recent years.
At Dartmouth Hitchcock Medical Center, hospital leaders posted a video this week warning patients to expect wait times of up to 24 hours for non-life-threatening conditions.
“The demand for post-acute care, skilled nursing facility and other post-hospital resources has never been higher,” Dr. Colin Stack, an emergency medicine doctor at Dartmouth, said in an emailed statement.
In a recorded statement, Dr. Joanne Conroy, the CEO of Dartmouth Health, said seasonal illnesses and staffing shortages are other factors contributing to the long wait times, along with “an unprecedented volume of patients with very complex medical needs.”
In Burlington, the University of Vermont Medical Center has also seen an uptick in patients visiting the emergency department in recent weeks. On some days, they've seen dozens more than their historic daily average of around 180 patients, according to a hospital representative.
In some ways, the current moment feels similar to the surges during the COVID pandemic, according to Dobson.
“From my vantage point, the demand for resources are at least the same, if not higher, than they've ever been,” he said. “It is the slow down in getting patients to the right location that is creating the volume and the problem.”
Not every hospital in the area has been so slammed. A representative from Rutland Regional Medical Center said they weren’t experiencing any unusual wait times this week — it was just a typical day.
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