Monkey See
10:25 am
Thu June 21, 2012

Silverdocs: The Scramble For Care In 'The Waiting Room'

Highland Hospital in Oakland has what's supposed to be an emergency room, and that's where the documentary The Waiting Room is set.

But as it turns out, at a big public hospital in Oakland, an ER only does so much actual trauma care; it only handles so many things you would usually think of as emergencies. The rest of the time, it functions as a primary care health provider that's not at all designed to be one — largely for people who have no insurance.

You meet a girl whose sore throat has become so serious that her neck is badly swollen and she can only open her mouth halfway. Her parents would have brought her to a regular doctor if they had one, or if they could afford it, but they're divorced and her father has been out of work for a year, so this is where she winds up — miserable, with a high fever and a racing heart rate, breathing through her mouth.

You meet a lovely young man and his girlfriend, who are doing what a lot of young, healthy people of limited means do: gambling on going without insurance. It's a plan that seemingly worked out all right until the day he was diagnosed with a testicular tumor.

You meet a man who's brought in after a night of heavy drug use, who even after he recovers physically can't be discharged because he has literally nowhere to go. A man who had a stroke a few days ago and can't get an appointment to see a regular doctor for a follow-up. A carpet-layer with terrible back pain who needs surgery but has to settle for pain medication — reliance on which, of course, carries its own risks.

All these people wind up using the ER as their primary doctor, essentially, for economic reasons, and it's easy to see that they often wind up getting much more expensive care than they would have needed if they could just see doctors at the doctor's office like people with insurance do. It's a lot cheaper to treat a kid for low-level strep throat, after all, than it is to wait until she needs to sit in the ER with an IV in her arm.

The Waiting Room contains no narration and no talking-head interviews with experts. It suggests no specific solutions. It has one goal and one goal only, and that is to vividly illustrate what the system we have right now looks like in the ER of a large public hospital – a place one doctor calls "an institution of last resort."

The film's real thesis, I think, is that this way of doing things is both more expensive and worse at providing care than any system you could invent where people see doctors before they're in a state that takes them to the ER.

As depressing as the state of affairs proves to be at Highland, the film is terrific; they've smartly selected both the staff members who participate — Dr. Doug White and Certified Nurse Assistant Cynthia Johnson are two of the more engaging personalities I've seen in workplace documentaries lately — and the patients to follow.

The Waiting Room is often dryly funny; it's very tense at times; it's emotional, and it's not didactic, which it easily could have been. It is frustrating, to be sure, but that's sort of the point.

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.