When Dr. Trey Dobson started practicing emergency medicine in Vermont 20 years ago, he might arrive in the morning to see one patient who came in overnight still waiting to be discharged to a skilled nursing facility or rehab center.
Now, there are often five to eight patients in the emergency department each morning, waiting for a place to go.
鈥淭hat's a third to a half of our emergency department,鈥� Dobson said. He鈥檚 the chief medical officer at Southwestern Vermont Medical Center in Bennington, and he also works at the emergency department at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire.
鈥淭hese patients, they might have been waiting 24 hours or 48 hours,鈥� he said. 鈥淎nd you can鈥檛 bring them into the hospital because they don鈥檛 meet the regulatory requirements for inpatient hospitalization.鈥�
The problem of not having an appropriate place to discharge patients who aren鈥檛 sick enough to be in the hospital but aren鈥檛 well enough to go home on their own is creating a backlog in emergency rooms across the region.
鈥淓very hospital in the state is caring for patients who could move to another setting if it were available,鈥� several emergency medicine doctors wrote in a . That鈥檚 as dozens of residential care facilities in the state have closed in recent years.
At Dartmouth Hitchcock Medical Center, hospital leaders this week warning patients to expect wait times of up to 24 hours for non-life-threatening conditions.
鈥淭he demand for post-acute care, skilled nursing facility and other post-hospital resources has never been higher,鈥� Dr. Colin Stack, an emergency medicine doctor at Dartmouth, said in an emailed statement.
In a recorded statement, Dr. Joanne Conroy, the CEO of Dartmouth Health, said seasonal illnesses and staffing shortages are other factors contributing to the long wait times, along with 鈥渁n unprecedented volume of patients with very complex medical needs.鈥�
In Burlington, the University of Vermont Medical Center has also seen an uptick in patients visiting the emergency department in recent weeks. On some days, they've seen dozens more than their historic daily average of around 180 patients, according to a hospital representative.
In some ways, the current moment feels similar to the surges during the COVID pandemic, according to Dobson.
鈥淔rom my vantage point, the demand for resources are at least the same, if not higher, than they've ever been,鈥� he said. 鈥淚t is the slow down in getting patients to the right location that is creating the volume and the problem.鈥�
Not every hospital in the area has been so slammed. A representative from Rutland Regional Medical Center said they weren鈥檛 experiencing any unusual wait times this week 鈥� it was just a typical day.
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