My background had previously been practicing emergency medicine at academic medical centers and serving in various leadership roles at the state and national level with the American College of Emergency Physicians (ACEP). I started becoming frustrated by hospital inefficiencies, long patient wait times, suboptimal patient care, and physician burn-out in a hospital setting. I started moonlighting at Inwood and Full Spectrum Emergency Rooms, both physician-owned independent free standing emergency departments about 18 months ago. I quickly realized how free standing departments offer a much better health care delivery model and I have been hooked ever since. I now work full time at Full Spectrum ER, part time at First Choice ER, and am the first free-standing emergency physician to serve on the Board of Directors for ACEP. As a national leader for our specialty, I serve as the Board liaison to our free-standing section and advocate for physician satisfaction, excellence in patient care, and improved health care delivery through free standing emergency medicine.

I find the most rewarding aspect of owning and practicing in stand –alone emergency departments is the ability to take back control of our practice. Emergency physicians are no longer hiding in the basements of hospitals or subjecting ourselves to inefficiencies of hospital based care. We can provide better quality, spend more time with our patients, improve patient and physician satisfaction, and maintain ownership of our practice. Consultants and hospital administrators now compete to get our business rather than control how we practice.

The biggest challenge our industry faces right now is fighting insurance companies for fair compensation and holding them accountable for offering adequate networks of care. The insurance companies are spending a lot of time and money promoting negative and misleading information about free standing emergency departments. We are under attack. They are telling legislators and patients that we are “glorified urgent cares” and grossly overcharging for our services. They are purposefully keeping us out of network to limit patient access and cutting reimbursement to pad their profits, cost shifting expenses to patients and providers. They are telling lawmakers that freestanding emergency departments are driving up the cost of care and intentionally misleading patients. It gets me insane because nothing could be further from the truth, but they continue to propagate these lies all over the media.

The single greatest benefit of TAFEC is that it gives us a unified voice to fight back. We can stand together and educate patients, the public, and our legislators on the value FSEDs bring to our communities. We can prove that we are cheaper than hospitals and provide better quality care. We can show that we are so much more than urgent cares and are able care for critically ill patients 24 hours a day. FSEDs can be an essential part of health care reform by providing increased access, price transparency, competition and free market capitalism, which will drive down costs and improve quality.

The message I would like to share with other emergency physicians is that we need you to get involved. Now. We cannot fight this alone. We need you to share your voice, tell your stories, speak with your legislators, and protect our industry. Please contact me at to find out how you can make a difference.

Gillian Schmitz, MD, FACEP

Emergency Physician- Spectrum Healthcare/ Full Spectrum ER

Board of Directors, American College of Emergency Physicians