Physician Discretion and Patient Pick-up: How Familiarity Encourages Multitasking in the Emergency Department

Abstract

Patient demand for emergency medical services has never been greater. In the United States, as fewer people access medical care through a primary care provider, more people access care through the hospital emergency department (ED). Unlike other types of queuing systems, however, the ED allows physicians discretion in whom they serve. That is, ED queues do not operate solely under a policy of “first-come, first-served, by severity.” Therefore, we wanted to know: “What leads physicians to select which patients, and how many patients, they will treat?” We explore how familiarity between peer physicians affects patient selection and the chosen multitasking level, a process more commonly known in the ED as “patient pick-up.” We find greater familiarity leads to an increase in patient pick-up rate, observed multitasking, and shorter patient wait time, with no identifiable negative impact to patient processing time or length of stay.