In 2017, there were 41 thousand visits to the 30 treatment rooms in the emergency department at Physicians Regional (St. Mary's Hospital). Now that it has closed the other hospitals in the area have to accept possibly 41,000 more ER visits a year. That is a lot to absorb.

Tennova North Knoxville, Fort Sanders, and UT Medical Center appear to be feeling the most affects.

The shutdown has reportedly affected ambulance services as well.

AMR has been dealing with ambulance shortages, in part because ambulances are tied up with lengthy off-load delays in overcrowded hospital emergency rooms, the ambulance service told the News Sentinel last month.

In an attempt to get more ambulances on the road, Knox County is temporarily changing its contract with ambulance provider AMR (Rural/Metro). County Mayor Glenn Jacobs' office announced Monday a 90-day agreement will allow Basic Life Support ambulances to respond to all but the most severe calls. Normally, the contract requires AMR respond to calls with Advanced Life Support ambulances, which carry more equipment, but of which there are fewer.

Did you know that for a Medicare recipient to get admitted to a skilled nursing facility for rehabilitation therapy they have to be admitted to a general hospital as an inpatient for 3 days? This means that if you are getting observation services, the day(s) under observation do not count towards inpatient status in a hospital. Sitting in the ER would not be included as an inpatient day. Thus, a woman referenced in this article that spent 24 hours in the ER waiting to be admitted would have lost a full day if there had been a need to go to a skilled nursing facility for rehab. It's possible there are clauses in many private health insurance contracts with this requirement.

About five years ago I had to meet an elderly person at the UT Medical Center ER after that person had been taken there by ambulance. When I arrived the elderly person was on a hospital stretcher in the hall near the ER criminal intake area. Not a pleasant experience for this person. Luckily actually being in the ER gets you close to the services you need if it becomes unbearable or life threatening.

I worked at UT Medical Center for about five years, many moons ago. To this day I admire all they do for their patients, employees, and the community. I just hope they can keep up with demand and changes in society.

Let's hope the remaining open hospitals in the area and the ambulance services can continue to provide excellent services as expected.