The practice of medicine has changed a lot in the 15 years.  The emergency medical care that we provide our patients has improved significantly.  However, this is true in spite of the fact that forces outside emergency physicians’ control have needlessly increased the emotional, mental, physical, and time burden on us as individual physicians. Physicians have less control over our hospital-based practice environment than ever before.

I realized that taking back control of our practice is not only in the best interest of the physicians and staff, but also is in the best interest of the patients we serve.

I started my journey in freestanding emergency center care as the medical director at Five Star ER in Dripping Springs and found that this model was a better way to deliver emergency medical care in America.

I love it when we get the “wow!” from patients, which happens almost every day.  Patients walk in to Five Star ER and are blown away by our clean modern design, how quickly they are seen by a board certified emergency physician, the time that we are able to spend with them addressing their medical concerns, and the quality of care we provide.

There are two big challenges for us at Five Star ER.

The first is getting the patient to understand what we are and the services we provide. Despite signage that clearly states “emergency room,” patients sometimes present at our facility thinking we are an urgent care. At Five Star ER, we are very transparent about our capabilities and the costs associated with emergency care.  If a patient is better suited for an urgent care, we are happy to refer them across the street to an urgent care facility.

The second issue is getting the patient to understand that we did not choose their insurance plan for them. Increasingly, patients incur high out of pocket costs because they unknowingly bought a policy from their insurance company that pushes the majority of expense to the member.  The insurance companies have done a great job vilifying emergency providers in these scenarios.  However, we have to educate the patient that their costs are due to inadequate coverage by their insurance company, rather than inappropriately high medical service costs.

TAFEC is critical to our industry. Insurance companies are mistreating FECs and aggressively spreading misinformation to deflect from the fact that they are pushing more of the financial burden on to the members of their plans that they “serve.”  TAFEC provides freestanding emergency providers with an organized and collective voice to combat these messages that are anti-business and, quite frankly, anti-patient.

Being an emergency physician is an honor.  However, so much is changing in medicine and in society that we, as a specialty, need to either stand up for ourselves and our patients or become a doormat for misinformed politicians and the insurance industry. Building a better model for emergency care has reenergized my professional life and allowed me provide the type of high-quality emergency care that my patients deserve.