There is a new kind of emergency medicine job emerging in the US. It is nearly identical to its counterpart in a hospital-based emergency room, except for one crucial fact: workers are employed by freestanding emergency rooms. Given the opportunity, would you work at a freestanding emergency room?
The medical aspects of emergency medicine do not change all that much with the environment. Ordering x-rays and setting a broken leg are pretty standard whether you are a doctor at a local hospital ER or you work for a freestanding emergency operation. Yet there still are differences. Some are good, others not so much.
The Freestanding Concept
The idea behind the freestanding emergency room is to provide the same kind of critical emergency care but without all the baggage that comes with operating inside the hospital. By law, freestanding emergency rooms have to do all the same things that their hospital-based counterparts must do.
They must provide the highest quality of care. They must follow laws regarding patient records and privacy. They cannot turn patients away based on the ability to pay. So what’s different? At the top of the list is foot traffic. Freestanding emergency rooms treat fewer patients.
Shorter Wait Times
Freestanding emergency rooms are a lot like after hours primary care in the sense that they do not see as many patients. This theoretically translates into shorter wait times. Provided your local freestanding ER is not exceptionally busy, patients can get in and out in fairly short order. Those same patients could spend an entire day at the hospital ER.
From the clinician’s perspective, shorter wait times translates into not being under so much pressure to move cases along. Fewer patients to treat means more time available for each one. It means less of a focus on patient volume and a greater emphasis on patient outcome. That alone is enough to make emergency medicine jobs at freestanding ERs attractive.
Less Bureaucratic Red Tape
Another benefit of setting up a freestanding emergency room is being able to provide critical care without so much bureaucratic red tape. Unlike hospital-based ERs, freestanding ERs are not competing with dozens of other departments for funding resources. ER doctors and nurses are not having to go head-to-head with administrators to see to it that department improvements are made. The list goes on.
The Higher Cost of Care
Freestanding emergency rooms do have their negatives. One is a generally higher cost of care. According to WUSF News, emergency care at a freestanding ER can cost up to 22 times more than the same care provided by a hospital and 19 times more than an urgent care center. The data they cited came from a UnitedHealth Group study that compared the cost of emergency care across multiple channels.
As a clinician at a freestanding emergency room, you would be working in an environment that charges a lot more. Would you consider yourself a contributor to higher healthcare costs, or would you be able to separate your job from the cost factor entirely?
Freedom to Choose
It is easy to take a position one way or the other regarding the legitimacy of freestanding emergency rooms. Yet the reality of this emerging form of emergency medicine is not so black and white. Freestanding ERs have a lot of good to contribute. They also cost more. In the end, individual choice is what matters.
If you are an emergency medicine physician, you get to choose where you want to work. Likewise, patients have the opportunity to choose where they will seek medical care. It is all good.
