By Nick Peters
Originally posted in the Dallas Morning News
That new free-standing emergency center in your neighborhood might look like just a mini-hospital or a shiny urgent care facility, but it is not. Free-standing emergency centers are equipped for full emergency care, and they offer patients an alternative to crowded hospital emergency rooms.
There is absolutely no evidence indicating that free-standing emergency centers produce poorer patient outcomes than hospital-based ERs. Nor is there any data suggesting patients are more at risk by seeking treatment at a free-standing facility. The same clinical quality standards and goals used in hospitals are used in freestanding emergency centers. These results are monitored closely to ensure the highest possible level of care, and it is not uncommon for free-standing centers to outperform hospital ERs.
Further, free-standing emergency centers don’t have the overcrowding, infection risks and chronic understaffing issues hospital ERs have been dealing with the last 40 years.
The Texas Legislature should be commended for creating clear guidelines for operators and establishing comprehensive regulations to ensure free-standing facilities provide the same levels of service as hospital-based ERs, which they do.
Free-standing emergency centers are required to have a trained ER physician and registered nurse onsite 24/7, just like a hospital ER. Urgent care clinics are not. At times, a physician’s assistant will be the highest trained medical professional at an urgent care. Nearly all free-standing emergency center clinical staffers have experience working in a hospital-based ER, and many continue to split time between a hospital ER and the free-standing center.
Just like hospital-based ERs, free-standing emergency centers are required to be open 24/7, 365 days a year. Urgent care clinics have limited hours and may require appointments before visiting.
Free-standing emergency centers are equipped to handle serious emergencies, including heart attacks, strokes, lacerations and broken bones, at a moment’s notice, and must maintain state-of-the-art equipment to quickly diagnose and treat emergencies.
The centers also have laboratory and radiology equipment, including CT scanners, ultrasound and X-ray machines, and are able to run tests, process results efficiently and stabilize patients accordingly. Urgent care clinics are unable to treat patients with serious emergencies and are not required to house such complex medical equipment.
Some critics worry that patients are typically diagnosed in a free-standing emergency center and then transferred to a hospital-based ER, boosting costs and losing time for treatment. This is simply not true. When another level of care is needed, both hospitals and free-standing centers must transfer their patients to a separate department. The only difference is hospitals usually do this by stretcher and freestanding emergency centers by ambulance.
When a free-standing center transfers a patient for hospital-based service, that patient bypasses the hospital ER for direct admission to a room, procedure suit or operating room. The ambulance transfer is typically covered by a patient’s insurance, and freestanding centers send all test and lab results so the necessary information is available to ensure a smooth transition. The rare exception is when the hospital refuses to admit the patient directly and requires the patient to be sent to the ER.
That said, whether at a free-standing emergency center or a hospital-based ER, the vast majority of patients who visit an ER do not require surgery or inpatient services. Free-standing centers provide real value to patients, and that includes offering things hospitals typically cannot, like shorter wait times. Research shows that long wait times contribute to poor patient outcomes.
This is not a criticism of hospitals, which must deal with a host of issues. Freestanding centers simply are able to focus on doing one thing, and doing it well.
Free-standing centers do not charge any differently than hospital ERs. Since the staff, doctors, equipment and care is the same as a hospital ER, the billing is very consistent.
In Texas, free-standing emergency centers have been able to cultivate strong relationships with hospitals because hospitals recognize the importance of prompt care. That’s why many hospitals have chosen to open their own standalone ER facilities. Hospitals have been great partners to free-standing centers, helping ensure patient transfers run smoothly. The centers give patients a choice for emergency care and help with hospital ER overcrowding.
Emergency care is changing, and we must embrace new, innovative models like freestanding emergency centers and determine how they can best be used to advance our overall health care system.
Dr. Nick Peters is chief medical officer for Advance ER, a free-standing emergency center in Dallas, and a board member of the Texas Association of Freestanding Emergency Centers. Email: firstname.lastname@example.org
Originally posted in the Dallas Morning News