The worsening problem of ambulance diversions stems more from lack of specialty physicians for a certain medical situation than from general overcrowding in the emergency room, according to a 2003 survey of 681 emergency department managers and administrators. Only 18% of respondents said overcrowding caused them to divert patients to other hospitals, compared with 36% of respondents to a 2001 survey.
Lack of physician specialty coverage, however, caused three-fourths of surveyed ERs to divert patients to a hospital that had the appropriate specialist available for emergencies, up from 63% in 2001. About one-third of hospitals surveyed said they had lost some specialists willing to be on call for the ER during the past 12 months. Largely because of inadequate specialist coverage, 15% of administrators said they would not choose to go to their own hospital's ER if they were seriously injured. The survey by the Schumacher Group, a Lafayette, La.-based ER management firm, was conducted in October and November 2003.