He later joined his wife in Seattle, where he took up a residency at the University of Washington and pinged around among Harborview, UW Medical Center, and Madigan Army Medical Center. And when, in 2004, the time came to find a job, a fellow doctor at Madigan suggested a little community hospital in Burien. The people there are top notch, he said. “Greg, you should check it out.”
Six years later, on a warm weeknight in June, Garcia, now overseeing 21 other docs as Highline’s emergency medical director, spun into action at the sound of an old-fashioned telephone ring. He picked up the red phone in the fishbowl, the line that paramedics use to call the ER when they’re en route with a patient. “Garcia.” He nodded as he scribbled on a pad of paper. “Okay. Okay. All right. See you soon.” The incoming patient, he’d learned, was bleeding profusely from his rectum. Within five minutes the ambulance crew wheeled the patient in, his face cloaked under an oxygen mask. He has liver disease, the bald and burly paramedic explained, and he’s a heroin user.
The intravenous drug use had rendered the patient’s veins so useless that the nurses couldn’t take a blood sample. In order for the staff to administer medication and draw the patient’s blood, Garcia would have to insert a central line into the patient’s neck, tapping into an artery. He donned surgical gloves, mask, and gown, and pulled the exam room curtain shut. The patient began screaming. “It’s okay. It’s okay. I’m almost done,” the doctor said. Finally, he stepped back from the curtain. Blood covered his gown and gloves. “Poor guy,” he whispered, pulling his COW out of the room.
Highline Medical Center—just a few miles from Sea-Tac airport, SeaTac federal detention center, upscale Normandy Park, and the Somali and Ethiopian refugee strongholds of Tukwila and Burien—treats a diverse population: patients with top-of-the-line insurance, homeless people, illegal aliens, prison inmates (one came in toward the end of the night, flanked by four armed guards), and airline passengers.
During his shift, Garcia examined a woman who’d been kicked off a plane for intoxication and another who complained of chest pains but whose body fat rendered the X-ray nearly useless. (“That’s happening more and more,” he said. “Obesity is a big medical problem in America, even bigger than it was when I first started in medicine.”) He spotted a kidney stone in one man and determined that there was a chunk of broccoli lodged in the esophagus of another. Later he checked the vitals on a schizophrenic patient who paced the room and watched cartoons throughout the exam.
Garcia, a standout in the growing legion of customer-service-oriented docs, pays close attention to the amount of time patients have spent since setting foot in the unit. Jabbing a finger at his monitor, which tracks the time elapsed since the patient checked in, he said, “That lady’s been here too long,” then vanished down the hallway to her room.
Nationally, emergency patients wait about 40 minutes, on average, before seeing a doctor. But Highline’s expanded treatment space allows the hospital to usher patients out of the lobby within minutes of arrival. Check-in happens in the exam room. A Highline ER doc’s shift, then, simply becomes a matter of clearing the COW screen—by either discharging patients or admitting them to a hospital room.
The emphasis on patient satisfaction is working. In June, among nearly 500 hospitals nationwide, Highline’s ER scored in the 99th percentile in customer-satisfaction surveys, compared to 70th percentile a year earlier.
Those satisfied customers include patients who come in without any real symptoms—which happens way more than the public realizes, Garcia says. At least one patient that June night displayed, in layman’s terms, hypochondriac-like behavior. His chief medical complaint “a real awareness of my heartbeats.” Yet Garcia treated him with the same care and concern he treated a subsequent patient who was likely in the middle of a genuine heart attack.
“I want to make sure everything is okay before I send you away,” he told the anxious man. “Just so that we both feel better.”
Published: August 2010
Wow, i can’t believe anyone likes that place. I’ve been there many times before and they treat like crap. It’s a poorly managed excuse of a hospital. I hope they go out of business so that we can get a real hospital to serve this community. The quicker the better! Amen!
Dr. Garcia is one of my FAVORITE ER Dr.s and has taken AMAZING care of my aging yet spunky Grandmother! To be honest, we always have a blast in the ER at Highline!!!! Although the situations are never ideal, the staff makes it FUN! To quote Dr. Garcia “The ER is open 24/7 and there for you!” Thanks for everything!!!