Freestanding facilities take pressure off hospitals

With the Katy area's population nearly doubling between 2000 and 2010 to 269,000, the need for medical care has also rapidly increased.

By the end of December, two freestanding emergency rooms and two urgent care clinics will have opened their doors in the Katy area in the last year. That brings the count of medical facilities to four freestanding emergency rooms, four hospitals and eight urgent care clinics in the community.

"The freestanding ER has really come out of necessity," said Dr. Winnie King, a partner in Priority Emergency Room.

Growing demand

King said the nationwide lack of primary care doctors coupled with a large number of uninsured people has placed high demands on hospital emergency rooms where the wait to be seen can often be several hours.

"Everyone in medicine knows we don't have enough [hospital beds] right now," she said.

She said people who are severely sick or injured suffer needlessly with long waits to be seen and treated at hospitals.

"For us this is a convenience issue but also a health issue," she said.

She said she is aware of problems related to delayed treatment. That is why she and the burgeoning number of freestanding emergency rooms and urgent care facilities have been opening their doors in the Katy area.

"There are not enough hospital beds, not enough emergency room beds, not enough medical facilities to handle the growth," said Dr. Ethan Brown, who, with his partner Dr. Christopher Fedoruk, will open The Emergency Room at Katy Main Street in late December.

Brown said he and Fedoruk are experienced emergency room physicians who have seen the need for faster and better emergency care.

"We will provide excellent quality and compassionate care," Brown said. "Our patients are not a number or an illness, but a person."

Brown said he chose Katy for his location because the city has been his family's home for 15 years and in that time he has seen the population expand. King said the population growth is why she and her partners opened Priority Emergency Room last January.

"We were looking for an area with a very dense population of families," she said. "We put our facility right in the heart of a very populated area."

Although Priority Emergency Room celebrates its first anniversary in January, King said she and her partners will celebrate by opening their second facility, this one in The Woodlands.

Collaboration with hospitals

Katy area hospital administrators agree there is the need for more emergency care services.

"Obviously there is a demand or they probably wouldn't put their shingles out there," said Jim Parisi, chief operating officer for Memorial Hermann Katy Hospital.

Parisi said when freestanding emergency rooms first began to surface a few years ago, Memorial Hermann and other hospitals aided Texas lawmakers in establishing minimum levels of care they had to meet to be certified.

The Freestanding Emergency Medical Care Facility Act was enacted in 2009 by the Texas Legislature, designating freestanding emergency medical care facilities as one that is "structurally separate and distinct from a hospital and which receives an individual and provides emergency care."

"We want to make sure that when someone puts the word 'emergency' on their building that patients are going to get a certain level of care," Parisi said.

Parisi said the free-standing emergency rooms are competition for the hospitals, but he added that it is a healthy and cooperative relationship.

Several emergency rooms and urgent care clinics have transportation agreements with local hospitals in case a higher level of care is needed.

"We do want patients to get the right level of care," Parisi said.

Although he disagrees with stories of very long waits in hospital emergency rooms, Parisi said there are times when they get so busy that people with lesser ailments are forced to wait while more life-threatening situations are dealt with. He said with freestanding facilities taking more of the load and methods of providing service improving, hospitals are streamlining operations and making emergency room visits better and more efficient for patients.

"I think we do a very good job of working and making the ER as efficient as it can be," he said.

Denise McCall, director of the emergency department at Methodist West Houston Hospital, said the medical community in Katy is close-knit and that many of the physicians at the freestanding emergency rooms have worked at some point in hospital emergency rooms. As a result, the facilities have kind of a friendly competition among them. When it comes to emergencies, however, she said they are all on the same side.

"We have to work for the patients. That's what we're all here for," she said.

Most of the freestanding facilities are miniature versions of hospital emergency rooms.

"We have all the services one would expect from a hospital-based emergency room," King said.

Insurance issues

Most all of the facilities accept major insurance companies. The freestanding emergency rooms, however, do not take Medicare and Medicaid.

"Medicare and Medicaid don't recognize freestanding facilities yet," Brown said.

One exception to that is HealthOne 24 Hour Emergency Care – West Campus on Grand Parkway.

"We are hospital-owned and take all forms of insurance, including Medicare and Medicaid," administrator Donny Abraham said.

HealthOne is part of the West Houston Medical Center, and even though it is located in a strip shopping center, it is a fully functioning emergency room complete with its own diagnostic lab.

"We want to make sure patients in the Katy community receive the same level of service as they do at our main campus," Abraham said.

He said the year-old facility is steadily growing and is in the process of creating a section of women's health care, including mammography services.

"The No. 1 thing is patient satisfaction and quality care," Abraham said.