Could Freestanding Emergency Rooms Be The Solution For Nations Overcrowded Emergency Care System?

By Author: Daniel Ruiz
Total Articles: 4
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For most people, a medical emergency means a trip to the nearest hospital followed by a long wait for emergency care. But for a growing number of people, the rush to the emergency room may now mean a shorter drive and faster care, without a hospital coming into the picture.

Increasingly across the United States, freestanding emergency rooms are appearing in neighborhood strip malls and office complexes. Their arrival could fundamentally change they way Americans get emergency care.

The emergency room is a crucial doorway into the American health care system. Americans made 120 million visits to the nation's approximately 4,600 hospital emergency rooms in 2006, according to the American Hospital Association. Yet the last decade has seen a shrinking of conventional emergency departments, even as the demand by Americans for emergency treatment has risen. The result is an overcrowded, overburdened emergency care system.

In this environment, freestanding emergency rooms have the potential to offer care that is better, cheaper and faster. Wait times can be reduced to minutes instead of hours.

At the same ...
... time, these facilities can deliver a high quality of emergency care, according to members of the industry.

"We refer 3-4% of our patients to hospitals for an overnight stay," says Rick Covert, Chief Executive Officer of Dallas-based First Choice Emergency Room. "This compares with 14% of hospital ER patients that experience overnight hospital stays from a referral from the hospital ER."

What makes the difference? Covert says his ERs can devote more time to stabilizing and observing a patient, while a hospital may send a patient to a hospital room simply to free up the ER bed for the next patient. This dynamic operates both ways: when hospital rooms aren't available, the ER system can develop a bottleneck because there is nowhere to put the ER patients. Hospitals are caught in a double-bind from having to manage overnight stays on top of medical issues, and the costs of treatment can escalate accordingly.

The advantage of the freestanding emergency room lies in its size. It can cost more than $100 million to build a new hospital, while a freestanding emergency room can cost less than $2 million. The math is clear: you can build freestanding emergency rooms in areas where building a complete hospital doesn't make sense.

Not only does this mean more emergency rooms serving more patients, but the ER can be closer to where the patient lives. Since it began in 2002, First Choice ER has opened twelve stand-alone ERs, most of them suburban neighborhoods and communities around Houston and Dallas.

The move toward freestanding emergency rooms mirrors broader trends in medical care over the last forty years. In the 1970s, the desire to see a doctor during evenings and weekends gave rise to neighborhood urgent care centers. Since the 1980s, surgical procedures have been moving out of the hospital and into ambulatory surgical centers performing outpatient surgery.

This trend toward decentralized medical care has given consumers more options at a lower cost, benefits that are shared by freestanding emergency rooms.

But while this new breed of emergency room helps relieve an overburdened emergency care system, it has taken time to gain acceptance within the existing system.

State legislatures and city ambulance services have sought assurance that freestanding emergency rooms provide the same quality of care that a hospital ER does. The state of Texas has recently enacted regulations detailing the requirements a facility must meet in order to call itself an emergency room. For example, Texas regulations say that any facility calling itself as an emergency room must have a CT scanner to provide advanced diagnostics on patients.

Covert says that First Choice ER supported the new law and the new regulations, and says these regulations are essential for building consumer confidence.

"These regulations help consumers know they are getting the same level of medical care they would get from a hospital," says Covert, "All of our ER docs are board certified and many have worked in the local hospital ER."

And First Choice directly admits its patients to local hospitals. "If a patient needs to go to the catheterization lab, we send them there directly just like the hospital ER would," says Covert. "We have the same personnel and equipment at our facilities and we provide a full file with the patient when transferring them to the hospital." Yet another example of how these new facilities can save time for the patient.

Visit the Texas Department of State Health Services for information about its rules governing freestanding emergency care facilities. Visit First Choice Emergency Room for information about the company.