In Canada's gridlocked emergency rooms, more sick patients are being treated in 'unconventional spaces,' including chairs, closets, and washrooms, as hospitals struggle with severe bed shortages. This practice, known as 'chair care' or 'waiting room medicine,' has become a routine default response to overcrowding, according to emergency physicians.
Internal Bleeding Missed in Chair Assessment
Dr. Fraser Mackay, an emergency physician in Saint John, New Brunswick, recently encountered a young woman with a minor shoulder injury who appeared to be in disproportionate pain. Seated in a public area of the ER with no stretcher available, she could not be properly assessed. Mackay suspected internal bleeding and ordered a bedside ultrasound, which required her to lie down—impossible without a stretcher. After his shift ended, he urged the incoming doctor to keep her until a stretcher became available. Hours later, the ultrasound revealed internal bleeding that required emergency surgery.
“It would have been very easy to say, ‘Well, if things get worse, come back later,'” Mackay said. “Who knows how long she could have sat there. And what if that stretcher hadn’t become available, and her bleeding had gotten worse? She shouldn’t have been assessed in a chair in the first place.”
ER Physicians Sound the Alarm
Toronto emergency physician Dr. Raghu Venugopal posted on social media: “ER chair medicine in Ontario (the awful cousin of hallway medicine) is unacceptable. Full stop. We need to get rid of it. We must fund hospitals and fix the problem of critically ill patients put in a chair. There is zero exaggeration here. I am sounding the alarm. Hear it.” Venugopal reported witnessing patients in extreme pain being kept in chairs.
These 'unconventional spaces' include converted ambulance bays, closets, and washrooms—areas never designed for emergency care, lacking oxygen, suction, nurse call bells, or privacy. Blankets are hung from IV poles to create makeshift curtains in chaotic hallways.
“While it may give the illusion of an acceptable version of medicine, care is guaranteed being compromised by the concept, ‘We can just see a patient in a chair,'” Mackay warned.
