Peter, one thing that served to break the backs of the ERs was insurance companies digging their heels in and refusing to pay the going freight. Interestingly, this was about the same time that the doc-in-the box shops started to spring up like unto mushrooms.
WRT trauma centers in most places, physicians who populate the most expensive of all specialties--neurosurgeons, cardiologists, vascular surgeons, orthopedic surgeons, plastic surgeons, ophthalmologists, anesthesiologists, et al--have to be kept available 365/24/7 to be physically present in the ER within 10 to 20 minutes of the arrival of any patient who might require their skills, whether or not revenue is coming through the doors.
Even putting aside the above, ERs must be staffed with your standard issue physician, nursing, and ancillary personnel 365/24/7, whether or not revenue is coming through the doors.
ERs are, for the most part, the hospital loss leaders. - Holly |
