PROFESSIONED plan: Quality control or anti-competitive?Exclusive contracts are widely used to ensure good care in the emergency department. But some say the system is outdated.By Tanya Albert, amednews staff. Aug. 26, 2002. A Texas emergency physician is challenging two hospitals' practices of signing an exclusive contract with emergency physicians who staff the ED, a common practice among hospitals nationwide. Emergency Medicine Associates and its manager, emergency physician Manuel J. Martin, MD, say that while the practice still has merit in some areas, it creates a monopoly that decreases competition among physicians and raises prices for patients in Austin, Texas, and Travis County. "Austin has two corporate groups that run the emergency rooms," said Dr. Martin, an Austin native. "Physicians have little to no say in improving the emergency room. Physicians see themselves as punch-the-clock employees. ... I said: 'I don't want my career to be about that.' I wanted more." Dr. Martin said he and about a dozen other physicians created Emergency Medicine Associates of Austin in September 2001 and were capable of covering emergency departments 24 hours a day, seven days a week. The group also had insurers and managed care companies willing to contract with them, according to the lawsuit filed in Travis County District Court. But according to the lawsuit, physicians with Emergency Medicine Associates weren't able to do business, because the area's two main hospitals already had exclusive contracts with other groups. Seton Medical System controls about 49% of the hospital market and had an exclusive contract with physicians who were a part of Emergency Service Partners. St. David's Medical Partnership controls about 41% of the hospital market and has an exclusive contract with Capital Emergency Associates, according to the lawsuit.
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Copyright 2002 American Medical Association. All rights reserved.
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