This situation has been exacerbated since the COVID-19 pandemic, with emergency room volumes in 2024 reported to be 10% above pre-pandemic levels.

In some cases, emergency room waiting areas have been converted into makeshift care zones, where patients are examined in lobbies rather than private areas, resulting in fragmented care and poorer patient outcomes.

The chaotic environment of overcrowded ERs not only affects patients but also compromises medical training, as young doctors miss essential face-to-face interactions that are crucial for developing clinical judgment and competence.

A study led by Dr. Katja Goldflam from Yale found that nearly three-quarters of emergency medicine residents reported negative impacts on their training due to boarding, leading to increased anxiety and diminished confidence in patient management.

Patients, often referred to as 'boarders', now occupy half or more of the available care space in many emergency departments, leading to a noticeable decline in the quality of patient care.

Factors contributing to increased boarding include financial pressures on hospitals, an aging population, limited access to primary care, and a lack of available aftercare services.

To improve healthcare, the authors advocate for increasing hospital capacity, enhancing primary care options, and transforming EDs into environments conducive to both patient care and medical education.

The article argues that simply calling to end boarding is ineffective, as it reflects deeper systemic issues within the healthcare system that require widespread reform and investment.

Emergency departments (EDs) across the United States are currently facing a severe crisis, with many resembling chaotic field hospitals due to an overwhelming number of patients waiting for hospital beds.

The authors emphasize that effective medical training cannot occur in rushed, overwhelmed settings, highlighting the need to address these systemic issues for the future of patient care.