Hospital-free ED: A growing trend

In the country's fast-growing suburbs, the freestanding emergency department -- without a hospital physically attached -- is the latest wave in medical facilities.

By Katherine Vogt, AMNews staff. Dec. 26, 2005.

It wasn't a hospital. Nor was it an urgent care center, clinic or medical office building. When the doors opened at Munroe Regional Medical Center's inaugural freestanding emergency department, the community of snowbirds and senior citizens near Ocala, Fla., didn't know what to make of it.

"People didn't know it was out there, and ambulances didn't know they could come out there and get people stabilized. It was difficult," said Joseph Yates, MD, medical director of Munroe's emergency department, who also works at the freestanding facility.

But three years later, the facility has no shortage of patients, demonstrating why the concept of the freestanding ED is growing more popular nationwide. "Now we're at the point where we're adding coverage during the day, and the nights are taking care of themselves," Dr. Yates said.

More than an urgent care center, the freestanding emergency department is open 24 hours a day to serve patients with most types of ailments, injuries and other medical needs. But those requiring hospitalization must be transferred. The facilities tend not to handle major trauma cases and instead are designed as a place for patients, particularly in the suburbs, to get immediate care.

Though the first freestanding emergency department opened in Virginia nearly 30 years ago, the model has been used sparingly, until recently.

Now, with increased pressure on traditional emergency departments, more hospitals are turning to freestanding EDs. For some, it eases problems caused by overcrowding or aging facilities. Others are building in fast-growing suburbs to chase shifting populations. No one has tracked the number of facilities being built, but observers say the interest in them is greater than ever.