Most of the patients now entering hospitals suffer from more than one physical problem; they are older, and have complex social circumstances that need to be addressed. A patient may have pneumonia that has stressed their heart, which has in turn affected their kidney and liver function. Many suffer delirium as a consequence of infection or pain, or simply from being moved from their usual surrounds. The ravages caused by life-long diabetes are starting to manifest. Diligently taking ten different prescribed medications has made them very sick. Their ability to cope at home is a precariously balanced tower of circumstance and luck.
What happens when these patients present to an emergency department? Who grants them entry to the institution and decides which bed, which ward, they end up in and which doctors will care for them? It may surprise you to hear that when your mother or your grandfather presents to a hospital, his or her arrival may set off a turf war. Doctors won’t fight to take care of him; they’ll fight not to.
– The Monthly