Ask the doctor: Why are waits in the emergency department so long?

Q. I sprained my ankle pretty badly a few weeks ago and was taken to the emergency room. It took three hours before I saw a doctor. Why are emergency rooms so crowded and the waits so long just to be seen?

A. The reasons for emergency department waits are complicated; our entire health care system is implicated. It is impossible to explain every aspect here, but one place to begin thinking about the problem is to separate waiting to be evaluated from waiting to be admitted to the hospital, if an evaluation shows that to be necessary. The reasons for each differ, although there is some overlap.

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