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Georgia hospital’s ED begins charging patients cash up front
Decision is aimed at reducing high numbers of non-emergencies

Gainesville, Georgia – Northeast Georgia Medical Center has taken the unusual step of charging patients cash up front for treatment of non-emergencies but advising them beforehand to obtain services at a local primary care facility.

Last month, hospital staff began evaluating patients on the basis of whether they had a true emergency condition. If it is determined that the patient has a non-emergency, the staff was instructed to offer the patient the option of going to a primary care provider or paying cash up front for services in the ED.

Uninsured patients are to pay a $150 deposit; insured patients must pay their co-payment or co-insurance. All patients with true emergencies will be treated without regard to their ability to pay, according to the hospital.

Northeast is reportedly following the lead of several metro Atlanta hospitals, which recently began a similar policy of persuading patients to seek care in appropriate settings.

“This is about encouraging personal responsibility and accountability,” said Northeast’s President Jim Gardner. About a third of Northeast’s 100,000 annual ED visits are considered non-emergencies. 

On-call surgeons will be paid extra to come in at Arizona hospital 
EPs see pay issue as a solution to the on-call problem

Phoenix, Ariz. – In what seems like a growing national trend, administrators and physicians at Muskogee Regional Medical Center have nailed down an agreement to pay a monetary compensation to some on-call specialists in exchange for providing services in the ED.

Under terms of the agreement, surgeons specializing in obstretrics/gynecology, orthopedics, and certain other surgical sub-specialties will receive $500 per day in exchange for their willingness to come and see patients in the ED for up to four days per month. They must, however, be willing to work on-call an additional four days within that month without compensation.

The agreement was negotiated in response to a temporary restraining order previously won by two general surgeons in an effort to block the hospital from trying to legally enforce the call schedule as part of the surgeons’ provider agreement.

The hospital also removed primary care physicians from the on-call schedule due to a plan to replace primaries with hospitalists.

Whistleblower alleges harassment after citing ED safety concerns
Physician claims her verbal complaints were ignored for months

Kahuku, Hawaii – The tranquil Pacific island setting of palms and sands seems a great deal less so these days for administrators at troubled Kahuku Medical Center and its ED. A member of the medical staff there has gone public citing deep concerns regarding the quality of some of her colleagues’ clinical skills and the overall level of care in the ED.

In early June, EP Laura Moire, MD, filed a formal complaint with hospital officials, including administrator Lance Segawa and a member of the board of trustees, outlining what she claimed was sloppy medical care that put patient health and safety at risk.

Moire said her grievances were continually ignored and that the medical staff retaliated after she formally complained by rifling through her file at work and disposing of many personal possessions. Hospital officials play down Moire’s charges, saying that the problems in the ED stem from past issues with a previous medical staff and that they have no record that Moire’s ever lodged informal complaints about the ED.

Rural Canadian EDs hang out “temporarily closed” signs
Unable to recruit EPs, hospitals divert patients to nearby facilities

Nova Scotia, Canada – In a show of what hospitals unhampered by EMTALA restrictions can legally do, at least two Canadian hospitals have begun to temporarily close their doors to patients, sending all comers, even emergency cases, to neighboring facilities with 24-hour services.

Last month, Digby General Hospital closed its doors to emergency patients for 12 days. The closures were maintained at 12-hour intervals and staggered over two-to-three days. Patients seeking emergency care and ambulance cases had to drive to one of two neighboring hospitals with fully operating EDs, according to Digby spokesperson Frazer Mooney.

In May, North Cumberland Memorial Hospital in Pugwash in northern Nova Scotia, also closed its doors for a 12-hour period beginning at 8 a.m. Hospitals are likely to continue closing their EDs at certain times, until the physician supply shortage is alleviated, Mooney stated.

A severe physician shortage nationwide is hampering providers’ ability to deliver prompt, quality medical care under the nation’s universal health care law.


EM group gives hospital $500K to help pay for expansion
Practice says it wants to ‘give back to the community’

Fresno, California – Physicians of Community Emergency Medical Group are literally buying into the notion of improving the quality of emergency care at Clovis Community Medical Center by presenting the hospital with a monetary gift to help expand the hospital’s ED.

The $500,000 “altruistic gift” will come from the 12-member medical group to help defray the cost of adding floor space that will double patient capacity in the ED, increase comfort and privacy, and update existing equipment and technology.

The ED expansion is part two of a two-phase hospital construction project that will include a two-story, 22,500 sq. ft. outpatient center at a cost of $20 million. The cost of the ED phase has yet to be determined.

Keith Grazier, MD, a managing partner with Community Emergency told reporters the gift was strictly altruistic and that the medical practice will have no financial stake in the not-for-profit hospital’s ED operations. Community Emergency has reportedly given other financial gifts in the past, including the development of a cancer center and a critical care wing.
 
 
Don’t just read the news talk back.
Think on-call specialists should get paid more to take call?
What about Canadia EDs that are closing?
Join the dialogue...

 

Comments   

# Emergency Medicine Physiciananon 2008-07-25 20:50
Regarding the Canadian ER's "closed" sign, that's sadly one thing you'll NEVER see/hear the mainstream media reporting on. They hold that system as the Nirvana that we should esteem to. Perhaps if they gave their physicians more autonomy and maybe a little more financial incentive, there wouldn't be a shortage. Hmmm, there's an idea. But it would that system would never work here (U.S.).... Could you just imagine the snit people would have when told, "Your CT appointment for that lump is 3 and a half months from this Monday?"

On the $500K "Gift" from the ER group to the Hospital in Fresno California, I have a fellow physician friend who had something similar in a Southeastern state. Except they were actually "buying" the assurance of their contract renewal from the hospital (i.e. you folks want to keep your jobs, what will you do for us?)

And people wonder why many ER journals/magazi nes are laced with stories of disgruntled and burned out EP's. Gee, maybe that's why they're projecting shortages here?
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# Northeast GA MedicalJC 2008-09-06 14:21
The care given in the ER at Northeast GA has gone down drastically. To be sent at Northeast GA main campus you may wait 2 or more hours. If you go to Lanier Park you get physicians that are not competent to care for patients. Five yrs ago Northeast GA was known for their care but they have lost that over the yrs.
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# Whistleblower or disgruntled employee?Anonymous 2008-12-21 12:41
I worked with Dr. Laura Moire at Kahuku Medical Centre, she made those allegations after she was fired. She was one of the worst physicians I have ever worked with.
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