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OPINION
The cost of a visit to an UCC is less than a visit to
a hospital-based emergency room (HBER) or
FSER for several reasons:
• HBERs invest in specialty equipment and staff that can care for
life-threatening illnesses or trauma and can move patients rapidly
and seamlessly towards definitive care. A large facility fee is
charged to all patients, regardless of the severity of the problem;
• HBERs and FSERs have an “emergency” approach to all medical
problems, generally resulting in extensive and costly "mega"
work-ups, even for relatively simple problems.
• FSERs exploit a provision in the law that allows them to charge
an expensive facility fee (just like a HBER) for simple urgent
type problems.
To make matters worse for consumers, FSERs are not connected to
or located within a full-service hospital. While their fees are just as
high as those found in a HBER, they suffer from a lack of proximity
to state-of-the-art definitive care services for problems like stroke, heart themselves and their employers to understand the differences be-
attack, or trauma requiring immediate surgery. All these more serious
patients must be transported to a hospital with the attendant delay,
thereby generating additional cost and medical risk.
The presumption that care is the same at a FSER and a HBER is
false and, at the very least, misleading. FSERs are more like UCCs.
While they are required to maintain much of the equipment and
staffing that a HBER does, they don't have rapid and seamless avail-
ability of definitive treatments in a true emergency. Thus, a need
for a cath lab, stroke center, or surgical suite always necessitates trans-
fer to a hospital, thereby wasting precious time.
And, in a true emergency, it is time that is the most critical com-
ponent to receiving quality care.
FSERs need to shoot straight and be transparent about the limi-
tations on the care, and the costs of that care, thereby allowing con-
sumers to choose what is best for their family’s health care and
pocket books. While employees may not concern themselves with
these higher costs if their insurance pays for a HBER or FSER visit,
they should know that their employers are the ultimate payers. The
high costs ultimately result in reduced salaries.
All employees, patients and their families have a responsibility to
tween costs and services provided at HBERs, FSERs and UCCs to
ensure they receive the appropriate care for the best value. Because,
I am pretty sure most do not want to pay $2,000 for the flu.
Dr. Bernard Swift is the founder and managing partner
of Texas MedClinic, a chain of 17 urgent care clinics located
in San Antonio, New Braunfels and the Austin area.
visit us at www.bcms.org 33