Now I guess it is no longer the McDonaldization of Health Care, it is the Dominoization:

Some hospital ERs begin guaranteeing quick service, or your room may be free
Don't look for all to join trend

By Del Jones
USA TODAY

Anyone who has spent half the night in an emergency room will welcome a trend that has some hospitals guaranteeing patients will be seen in 33 minutes or less.

The strategy has boosted visits as much as 54% at Northern Nevada Medical Center in Sparks near Lake Tahoe. Similar guarantees elsewhere:

•Robert Wood Johnson University Hospital in Hamilton, N.J., which won the Baldrige Quality Award last week, promises ER patients will see a nurse within 15 minutes, a doctor within 30 or the room is free.

•CentraState Healthcare in Freehold, N.J., offers the same.

•Central Montgomery Medical Center in Lansdale, Pa., guarantees a nurse will see patients in 15 minutes unless delayed by an emergency such as a heart attack, or the room is free.

•Medical Center of Southeastern Oklahoma in Durant promises triage in 15 minutes, or there is no room charge.

•Aurora Medical Centers in Green Bay, De Pere and Two Rivers, Wis., might have the most generous plan: Care must begin in 33 minutes or room and doctor fees are waived.

But don't expect ER guarantees to become universal, especially in inner cities and rural areas. For every hospital that wants to lure the sick and injured from competitors, there are others where non-emergencies are left to wait. Baptist Memorial in Memphis is among those urging people with flu symptoms to see a doctor.

Generally, ERs are overwhelmed. The average emergency department saw 24,300 patients in 2003, vs. 16,800 in 1990, according to American Hospital Association.

Yet, hospitals that offer guarantees say they rarely exceed their time limits. Robert Wood Johnson gives a free room less than once every 4,000 patients. Hospital billing is complicated, but the guarantees are worth about $100 to $500.

Source: [1] USA Today

The Emergency Department where I work sees 50,000 patients a year. Sometimes patients wait up to 6 hours to see a doctor — no guarantees here! If another hospital wants to pick up the slack, fine with me, but there isn't a great deal of underutilized ED capacity in my area. Mostly becuase of people coming in with dumb compaints, (like yesterday's my kid has been vomiting at school each day for the past 3 weeks), but that's for another post at another time.