With the worst of the COVID nightmare now behind us and the public health emergency ending in May, many of us hoped that the lessons of the pandemic would lead to positive changes in American healthcare -- which might ease the situation in the overrun emergency department (ED). That didn't materialize. [MedPage Today]

I suppose that if I had to use one word to describe the tone of the modern American emergency department, it would have to be "despair."

Our patients continue to despair for many reasons. No small number do so because they inhabit a nightmarish loop that goes from home or nursing home, to hospital, to rehab. Rinse, repeat. They are too sick for any urgent care or primary care office, so they come to the ED where we plug them back into the system as before, knowing their names and medical histories as soon as we see their exhausted faces on the EMS stretchers. Once admitted they end up in uncomfortable rooms in the ED with complex illnesses, but no free beds for inpatient admission.

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