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Free Standing Emergency Department vs Urgent Care

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  • Free Standing Emergency Department vs Urgent Care

    I had not heard of this until this news article:

    http://www.nbcnews.com/health/health-care/you-thought-it-was-urgent-care-center-until-you-got-n750906

    It discusses how some "free standing emergency departments" look like urgent care centers. From the tone of the article it definitely sounds misleading to have something that looks like an urgent care, NOT attached to a hospital, be considered an emergency department.  However, there are always at least two sides to a story.

    I am curious what the Emergency Medicine folks on here think about this.

  • #2
    A free standing ED has huge costs because they can handle big emergencies 24/7.  The doc on duty has to be able to receive every ambulance, resuscitate from shock, perform bedside ultrasound, have complex airway management skills for the patient with a full stomach, and so much more.  The nurses likewise have to be specialty trained and ready for anything on a moment's notice.  And advanced imaging capabilities (CT scanning) are needed as well.

    On the positive side, these free standing ED's are great for a community that does not have a local hospital available nearby with an ED to care for them.  Emergency care is closer, can be more timely, and more convenient.

    On the negative side, the cost of care in an ED is an order of magnitude more than care in an urgent care.  If you walk in with a cold, it will be a 4 figure bill instead of a 3 figure bill.  Ouch!  The consumer needs to be notified in advance.  Otherwise they are getting a huge surprise after the care has been rendered.  And it is in the best interest of the free standing ED not to chase anyone away as they need the lower acuity patients to keep them busy and to subsidize the expensive care that they are prepared to provide 24/7.

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    • #3
      I work shifts at a fsed.  Our nurses always inform the patients this is an emergency room, sometimes people leave but usually they stay.   Heck a lot of patients say, "o I don't care, Medicaid is paying  anyway and theirs no wait like the urgent cares ".

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      • #4




        I work shifts at a fsed.  Our nurses always inform the patients this is an emergency room, sometimes people leave but usually they stay.   Heck a lot of patients say, “o I don’t care, Medicaid is paying  anyway and theirs no wait like the urgent cares “.
        Click to expand...


        In my town, the urgent cares don't accept Medicaid (nor most specialists or primary docs for that matter).  (Medicaid: as one patient brightly announced to me, "full coverage insurance.")

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