New York University emergency department prioritizes the wealthy for treatment

New York University’s Ronald O. Perelman Center for Emergency Services prioritizes wealthy donors, politicians and celebrities for treatment at the expense of everyone else, according to an extensive investigation by the New York Times. Dozens of doctors and other health care workers report that administrators pressure them to treat rich and influential patients immediately for minor complaints, thus forcing patients with potentially life-threatening conditions to wait for urgently needed care. 

New York University’s Ronald O. Perelman Center for Emergency Services [Photo by Flickr user Eden, Janine and Jim / CC BY 4.0]

This practice, which is not unique to NYU, violates the principle of medical triage in the operation of emergency departments. Under this principle, the sickest patients receive treatment first, without regard for their ability to pay for care, and patients with less serious presentations wait their turn. More fundamentally, NYU’s discriminatory practice illustrates that the provision of health care is dominated by social inequality and the profit system. 

When Kenneth G. Langone, a billionaire and founder of Home Depot, came to the NYU emergency department with stomach pain in September 2021, he was quickly treated in a room that ostensibly is reserved for patients in critical condition. Langone is chair of the hospital’s board of trustees and has donated hundreds of millions of dollars to NYU’s hospital system. Langone’s symptoms were associated with a bacterial infection. 

In spring 2022, Democratic Senator Charles Schumer of New York brought his wife to the emergency department when she had a fever and was short of breath. Schumer and his wife were rushed into a room and tested for COVID-19. Meanwhile, sicker patients were being treated in the crowded emergency department’s hallways. 

On one occasion, a well-known actor with a headache and low-grade fever was placed at the front of the line for a CT scan, Dr. Michelle Romeo told the New York Times. When the actor demanded a spinal tap that Romeo thought was unnecessary, a supervisor told her to perform it anyway. The test results were normal. The actor was treated ahead of a patient from a nursing home who had possible sepsis and had been waiting three hours for treatment. 

NYU’s discriminatory treatment begins before the patient even arrives at the facility. The emergency room has a Trustee Access Line that donors can call to notify the hospital that they are on the way. Once alerted, administrators notify doctors through texts and emails that a high-profile patient is coming. The doctors understand implicitly that they are to give the patient priority treatment. Moreover, they fear the professional consequences of not doing so. 

In case the message is somehow missed, electronic medical charts point out that certain patients have donated to the hospital or have a relationship with one of its executives. A screenshot of one record from July 2020 that a doctor shared with the Times read, “Major trustee, please prioritize.” Workers report that they have been pulled from sicker patients to attend to wealthy patients with minor complaints. 

“It didn’t matter how busy it was. A V.I.P. was coming, and we had to drop everything,” Dr. Uché Blackstock told the Times. Blackstock left the NYU emergency room partly because of her objections to this discriminatory practice. 

No matter how serious their presentation is, workers and the poor must endure longer waits for care—if they are admitted to the facility at all. Ambulance workers report that NYU staff discourage them, and sometimes actively prevent them, from bringing homeless patients to the emergency department. They are told to bring these patients to Bellevue, an overtaxed public hospital that mainly treats the poor. “There isn’t a day that goes by that we don’t get an NYU dump,” said Kim Behrens, an experienced nurse at Bellevue, in an interview with the Times.

“As emergency department doctors, we have two important skills: triage and resuscitation,” Dr. Kimbia Arno told the Times. Speaking of NYU’s emergency room, Arno said, “This system is in direct defiance of what we do and what we were trained to do.” 

At least 11 doctors have resigned from the emergency department over their objections to NYU’s favoritism toward wealthy patients. In a wrongful termination lawsuit, Dr. Kristin Carmody, who supervised the education of residents in the department, said that she had been forced to resign in 2020 after a V.I.P. complained that she had not received the level of treatment she expected. 

By giving priority to millionaires and billionaires, executives at NYU and other hospitals are protecting the interests of the social class to which they themselves belong. In 2020, Steven J. Corwin, president and CEO of NewYork-Presbyterian hospital, received compensation totaling $10.7 million. Corwin was the highest-paid hospital executive in the New York metropolitan area that year, which was the first year of the pandemic. 

In fact, hospital executives throughout New York state used the pandemic as an opportunity to enrich themselves further, according to a USA Today investigation of federal tax records. In 2020, while they oversaw health systems that received billions of dollars in federal pandemic bailouts, more than 250 of the state’s hospital executives gained about $73 million in total bonuses. The average bonus was approximately $273,000.

During the same year, the average total compensation for about 364 hospital officials was $1 million, including salaries, bonuses and other payments. Ten executives had bonuses of $1 million or more, including the leaders of some of the state’s largest health systems, such as NewYork-Presbyterian, Northwell, Montefiore, Rochester Regional Health and Nuvance Health. The priority of this social layer is to increase its own profits, even at the expense of working people’s health. 

As of December 28, New York state had recorded 6,725,465 COVID-19 infections and 75,089 deaths since the beginning of the pandemic. New York City alone has officially had 3,118,742 total cases and 43,834 deaths. Because of the criminally inadequate testing and contact tracing infrastructure, these figures are certainly underestimates. 

New York City neighborhoods at greater socioeconomic disadvantage, which includes lower median income and poor access to health care, have had more COVID-19 infections and deaths, according to a study conducted by scientists at Mount Sinai in 2021. Lack of access to a primary care physician often means that workers in these neighborhoods only seek care in urgent situations by going to emergency rooms. It is precisely these workers whose lives are being jeopardized by health systems that, in their quest for profit, brush them aside as second-class citizens.