"Unacceptable to be sent 'round and round the ER'... Don't add burden to the struggling medical staff"

Jeonnam National University Hospital Emergency Medicine Professor Jo Yong-su's Opinion Revealed
"Is It Just to Wait 6 Hours in the Emergency Room?"
"Reality Is Complex, but Stigmatized as 'Emergency Room Spinning'"

Recently, Professor Cho Yong-su of the Department of Emergency Medicine at Chonnam National University Hospital, who became a topic of conversation for saving a teacher in their 20s who suffered cardiac arrest for 40 minutes after being struck by lightning, has drawn belated attention for his views on reports of "emergency room (ER) shuttling." On the 16th, through social media, Professor Cho stated, "Not all refusals of admission in the emergency room equate to 'ER shuttling,'" and questioned, "Is it right to blame those who were struggling in their positions for refusing patients?"

Professor Jo Yong-su, Department of Emergency Medicine, Chonnam National University Hospital. [Image source: Captured from Chonnam National University Hospital website]

Referring to a news article from the second day of the Chuseok holiday on the 15th, which reported that a patient with a severed finger was refused admission by four local medical institutions in Gwangju and was transported over 90 km away to Jeonju, Jeonbuk, for reattachment surgery, Professor Cho said, "The article was published just three hours after the refusal to admit the amputee," and added, "The article states that there were no doctors capable of performing reattachment surgery in Gwangju, but this is not true."

He explained, "At Chonnam National University Hospital, finger reattachment is mainly handled by the Department of Plastic Surgery. At the time of the incident, two plastic surgery specialists were on duty. One was performing surgery on another patient who had arrived earlier at the ER, and the other was continuously suturing a facial wound, while there were five laceration patients waiting," and argued, "It was not that there were no doctors capable of performing reattachment surgery, but that the doctors were too busy to admit the amputee."

He continued, "Surgery cannot be performed by a single surgeon alone. The operating room, anesthesiology, nurses, support staff, and equipment all need to be available for surgery to proceed," and explained, "Leaving the waiting patients unattended while suturing was ongoing could have led to a situation where new patients could not be admitted, potentially causing another instance of 'ER shuttling.'"

Furthermore, he stated, "The amputee patient mentioned in the report could have been admitted to the ER at Chonnam National University Hospital. They could have waited until the surgery on the earlier patient was finished," and questioned, "If they had waited about six hours, they would have received surgery, and no one would have complained, ending the incident peacefully. Is that just?" He suggested that instead of waiting six hours, moving to Jeonju within an hour to receive surgery might have been better for the patient.

An emergency patient who visited a hospital in Seoul on the 2nd is waiting at the hospital's main entrance. Photo by Jinhyung Kang aymsdream@

Professor Cho went on to say, "Emergency rooms cannot admit patients for various reasons. However, society lumps all these situations together and stigmatizes them as 'ER shuttling,'" and pointed out, "In some cases, they don't even realize that this tightens their own noose."

He added, "If 119 (emergency services) had left all patients at the ER without notice as in the past, the amputee patient would have wasted six hours at Chonnam National University Hospital," and said, "(The patient) spent time looking for the hospital where surgery could be performed the fastest. If this is 'ER shuttling,' then it is a good kind of shuttling that should be encouraged as an act of goodwill for the patient."

He also emphasized, "I understand what 'ER shuttling' means. I agree that it is a problem that must be solved. But not all refusals of admission in the emergency room are 'ER shuttling.' It is not easy to clearly distinguish this in the complex reality."