Patients at Maine emergency rooms wait anywhere from 10 minutes to nearly an hour to see a doctor, federal data show as the holidays usher in a seasonal spike in illnesses and injuries.
Wait times range from 51 minutes at Eastern Maine Medical Center in Bangor to 10 minutes at Mid Coast Hospital in Brunswick, according to data collected through 2012 by the Centers for Medicare and Medicaid Services.
Central Maine Medical Center wait time was reported at 44 minutes, and St. Mary's Regional Medical Center reported 20 minutes - - something it advertises on its website. Franklin Memorial Hospital in Farmington and Stephens Memorial Hospital in Norway report ER wait times of 25 minutes.
Maine's statewide average waiting time was 28 minutes, matching the national average, a tally of the data by ProPublica, an investigative journalism nonprofit, showed.
Hospitals voluntarily submit the data, and have a financial incentive to participate. In Maine, 22 of the state's 36 acute-care hospitals provided data. Ten posted ER wait times exceeding the national average, though three hospitals were within three minutes of the average.
While patients with life-threatening conditions are seen right away, in less urgent cases patients often wait to see a doctor.
The Centers for Medicare and Medicaid Services recently added the emergency room wait times to its Hospital Compare website, where consumers can view how their local hospital stacks up on various quality metrics. The move comes as overcrowding in emergency rooms has reached a "breaking point" in the U.S., according to an Institute of Medicine report that found ambulances are turned away from emergency departments once every minute on average. As demand for emergency care has grown -- with ERs providing much of the care for uninsured patients and in rural areas -- the number of emergency departments and hospital beds has declined, the report found.
In Maine, statewide studies have shown high rates of emergency department use, said Lisa Letourneau, executive director of Maine Quality Counts, a collaborative working to improve health care in Maine. Unless it's a life-threatening emergency, patients should always call their primary care provider before heading to the emergency department, she said.
"Primary care providers can often effectively care for many conditions without having to go to the ED ... Many primary care practices are working to improve their efficiency and scheduling to better accommodate patients and offer same day access to care, including offering extended office hours," she wrote in an email.
Maine hospitals struggle less with overcrowding than their counterparts in more urban areas, but ERs are often the only option when other health providers are closed, which can can lead to longer waits, said Jeff Austin, a lobbyist with the Maine Hospital Association. A greater problem is finding beds for patients with psychiatric issues, who can be transferred only to facilities licensed to handle them, he said.
"When a regular hospital has a patient in the ER because there is literally no licensed facility that can take the patient, our ERs suffer (as do the patients)," he wrote in an email. "We have to devote nurses to the patient full time 1-on-1. That means there is not enough staffing to care for the rest of the ER beds. So, work in the ER slows down."
Hospitals that treat a higher volume of patients with mental health or substance abuse problems often have longer wait times, postponing discharges until patients have sobered up or been transferred to psychiatric facilities.
Trauma centers such as EMMC also accept patients with critical injuries that must be prioritized over less urgent cases, said Dr. Brenda Gowesky, chief of emergency medicine at the Bangor hospital.
"Some of those patients take a little longer to take care of ... so other patients may have to wait a little longer to be seen for their care," she said.
Patients seek out EMMC for its up-to-date technology and high- quality care, and the hospital is working to improve wait times, such as by fast-tracking less acute patients to more appropriate care, Gowesky said.
The federal data averages wait times, lumping together critical patients, such as heart attack victims, with less urgent ER visits like ankle sprains or sinus infections. At EMMC, the emergency triage levels range from one, for the sickest patients, to five, explained Cathy Mingo, director of performance improvement and data management.
"What the public should really want to know is what's the wait time for a triage level one versus the wait time for a triage level 5," she said.
The data may not always accurately reflect wait times, as hospitals report a small random sample to the federal government and the figures are up to a year old by the time they're published, Mingo said. EMMC's own data, reflecting all ER volume so far this year, shows a wait time of 40 minutes to see a clinician, 11 minutes quicker than the reported time.
Some hospitals, including York Hospital and St. Mary's in Lewiston, advertise their ER waits in real time on their websites, though their definitions may vary from the federal government's.
Hospital emergency rooms often get especially crunched during the holidays. Emergencies spike this time of year as patients put off getting care, indulge in unhealthy foods and binge drink, a 2011 report by the University of California at San Francisco found.
Some patients also may feel lonely or depressed during the holiday season, said Mary McCarthy, an EMMC nurse and manager of telemedicine and emergency services.
"Sometimes they're just looking for a friendly face to spend some time with and the ER, we're always open," she said.
For additional information on Maine emergency room wait times, check out the "ER Wait Watcher" tool produced by ProPublica at projects.propublica.org/emergency.