Dr. Jeffrey Fitch,

Written by Dr. Jeffrey Fitch, Orlando Health South Lake Hospital Emergency Department Medical Director

When the siren is wailing and someone is trying to get your vital signs, you do not want the ambulance to have to travel any farther than absolutely necessary to get you in front of a doctor. That’s why the dramatic increase in Freestanding Emergency Rooms (FSERs) has been such a welcome development in many Florida communities.

Changes in regulations have made it easier for health care systems to place freestanding ERs in communities where they are needed without having to build an entire hospital. This has been especially valuable in fast-growing Florida where thousands of new residents are coming every day, and the freestanding ERs ensure access to high-quality emergency care.

If you’ve driven past a new FSER and wondered about it, here’s a few things you should know.

First, a freestanding emergency department is simply an emergency facility that’s physically unattached to a hospital building, but it is part of a health care system and it is affiliated with a hospital. Orlando Health’s freestanding ERs are each staffed by board-certified emergency medicine doctors and nurses who can care for adults and children at all times, 24-hours a day and seven days a week, including holidays.

A freestanding ER shouldn’t be confused with an urgent care center. An emergency department is where you should go if you have a life- or limb-threatening health condition, such as a broken bone or chest pain. If you or someone you are caring for has an illness or injury that isn’t that severe, but that can’t wait several days for an appointment with your regular physician, such as a case of the flu or a sprain, then urgent care is probably the right call. The bottom line, however, is that if you think something is an emergency, go to the ER.

 Although most emergency room patients are discharged home after receiving evaluation and treatment, about 25 to 30 percent of patients are admitted to a hospital for further treatment. And this is where the trend toward freestanding ERs can be confusing. You see, a freestanding ER isn’t just a place for emergency treatment, it is often a portal to a healthcare system.

So, if you go to a freestanding ER and need to be admitted to a hospital for continuing care, you will usually be transferred to the hospital that ER is affiliated with in order to maintain the proper continuity of care. That hospital, however, might not be the nearest hospital. In fact, I’ve heard of situations in which a patient in one freestanding ER could see their preferred hospital down the street, but they were admitted to the ER’s affiliated hospital which was miles away. This can make things complicated if you have established specialists caring for you who are part of a different health care system but not the one to which you were admitted.

With this issue aside, however, the growing number of freestanding ERs is adding emergency medical capacity to rural areas where access to emergency care has sometimes been inadequate and to fast-growing communities where the demand for care is outpacing the capacity of established hospitals. And that’s a very welcome addition to any community.

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