Physicians for Healthy Hospitals, which operates both Hemet Valley and Menifee Valley medical centers, announced they would follow a national trend and begin allowing patients to make online emergency room reservations.

Joel Bergenfeld, PHH CEO, said the move would relieve patients’ stress by allowing them to do their waiting at home, rather than in a crowded ER waiting room.

Hospitals administrators in other parts of the country who have adopted the program cite increased efficiency and benefits to medical staff of having a better sense in advance of the kinds of cases that would be coming in each day. They note it also is a way to shore up revenue by increasing patient satisfaction.

Some medical professionals believe having reservations for emergency rooms is oxymoronic, noting that by definition emergency rooms are for emergencies — serious and/or life-threatening cases and not conditions that don’t necessitate immediate medical attention. Critics stress non-emergent cases should be handled by urgent care facilities or by primary care physicians, leaving emergency rooms freer to treat true emergencies. They also note that emergency-room care is the most expensive, as opposed to urgent care or primary doctor visits.

Dr. Del Morris, president of the California Academy of Family Physicians and medical director of the Stanislaus County Health Services Agency said, “If the country wants to decrease health-care costs, patients need to be treated at the right place at the right time. Patients who can make appointments should do so at their doctor’s office.”

Sara Rosenbaum, a health law and policy professor at George Washington University, said the concept of ER reservations is inappropriate. “It’s concierge emergency departments and by definition, if you’re making an appointment, it’s not an emergency,” she said.

Richard Bitterman, president and CEO of Michigan-based Health Law Consulting Group, agrees with Rosenbaum. “It’s a wonderful system for urgent care or primary care, but it should be kept out the emergency departments,” he said. He also noted the system, which requires reservations be made by smart phones or online, discriminates against people without that access. “Poor people don’t have access to smart phones or computers.”
Proponents maintain that in a computerized age, the ER reservation system answers a need, calling this new patient option “Open Table” (the online restaurant reservation site) for medical appointments. Average wait times have increased at U.S. hospitals, from 47 to 58 minutes over the period from 2003 to 2009, according to a report by the National Center for Health Statistics. Bergenfeld’s group states that average ER wait times in Riverside County are significantly longer — two to four hours, depending on time of day and number of waiting patients.

There are a number of software companies now acting as schedulers for a gamut of medical appointments — from ER, to urgent care, family doctors and dentists. “We think everyone in America will be booking [medical appointments] online,” said Cyrus Massoumi, CEO of ZocDoc in New York. His company, new in the field, now books appointments for more than 6 million patients per month.

PHH’s website is simple to use. ER patients are able to hold a place in line by selecting an available time and not being more than 15 minutes for the appointment. They describe their symptoms and enter name, date of birth, gender, cell phone, email and whether they have ever visited the appointment hospital before. Terms and conditions stipulate that the applicant understands the service is not to be used for life-threatening conditions and that contact between applicant and hospital may sometimes contain sensitive, personal health information and that using emails with this information contains risks.

Appointment applicants are informed their reservation time is not a guarantee and that patients with more serious conditions would be seen first; that the service is free; that users do not have to have insurance to make a reservation but that once “stabilized,” they may be asked to make payment arrangements; and that they may not necessarily be seen by a doctor, but by a nurse, physician assistant or some other “combination of health care professionals.”

To make reservations for PHH hospitals, visit