Massachusetts Patients Face Third-Longest Emergency Room Waits in the U.S.

Massachusetts boasts some of the nation’s top hospitals, abundant physicians per capita, and high overall healthcare rankings—yet it struggles with some of the longest emergency department (ER) wait times in the United States. Recent data places the state consistently in the top three (or tied for third) for average time spent in the ER, with patients waiting 189 to 220 minutes (over three to nearly four hours) before discharge, far exceeding the national average.

This paradox stems from systemic pressures rather than a lack of medical expertise. High demand plays a key role: Massachusetts sees substantial ER utilization (around 473 visits per 1,000 people annually in some metrics), driven partly by limited access to primary care. Many residents face weeks- or months-long waits for primary care appointments, pushing non-emergent issues into ERs. Chronic understaffing, post-pandemic burnout, and nationwide healthcare worker shortages exacerbate the problem, leading to “boarding”—where admitted patients remain in ER hallways or rooms awaiting inpatient beds.

The consequences are severe. Extended waits increase patient suffering, delay critical care, and raise risks of adverse outcomes. In Massachusetts, reports highlight extreme cases: patients enduring 12–30 hours in pain, high rates of leaving without being seen (around 5% in some data, among the nation’s highest), and rising long-stay percentages. Despite strong resources like high nurse and doctor ratios, the system is overwhelmed by boarding and inefficient patient flow.

Addressing this requires targeted reforms: expanding primary care access to reduce unnecessary ER visits, incentivizing inpatient capacity, improving behavioral health integration (a major boarding driver), and bolstering workforce retention. Until then, Massachusetts’ ER delays highlight a broader truth—exceptional healthcare quality does not guarantee timely access when demand outstrips system capacity. For Bay State residents, a medical emergency too often means hours of waiting in an overcrowded department, underscoring the urgent need for change.