Thesis Statement
Though larger and busier, hospitals faced many familiar problems. They continued to be beset by troublesome management issues such as nursing shortages, labor unrest, potential employee unionization, the disruptions and inconveniences caused to patients by teaching, and the decrepit, overcrowded conditions in the outpatient departments. The emergency rooms and clinics of many teaching institutions served as a barometer of changing social conditions: the increase of unwed motherhood, or the changing ethnographic composition of the neighborhood.
Introduction
In the next three years, the number of uninsured may go up by nearly 25 percent and hit 50 million. Overcrowded emergency rooms are turning away 40 percent of incoming ambulances. Many private hospitals, looking to maximize profits, try to keep the number of vacant--that is, available--beds low, which means even those with coverage or the money to pay cannot always obtain care. Healthcare is again becoming a chief concern of middle-class Americans. A recent front-page New York Times article chronicled the increasing difficulty middle-income families are having finding affordable health insurance in this weak economy.
By the late 1980s emergency rooms and psychiatric units in general hospitals were routinely overcrowded, despite the 1,200 new acute psychiatric beds added to these hospitals in die 1980s. In fact, emergency rooms became the staging areas for a variety of social problems-homelessness, substance abuse, and criminal behavior. Studies demonstrated that a relatively small number of individuals were using a disproportionate number of emergency services and inpatient days. Patients were literally "bouncing between emergency rooms, general hospitals, state hospitals, outpatient services, jails, and homeless shelters without ever being effectively linked to appropriate services.
One example of a medical situation that would greatly benefit from collaborative trust and better communication is the diversion of ambulances from hospitals because of overcrowded emergency rooms. This is an.......
