Because all the physicians took ownership of the process and the hospital was enormously stable and successful, this concept worked quite well.

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ACEP Now: Vol 38 – No 03 – March 2019

Dedication Leads to Success

Because all the physicians took ownership of the process and the hospital was enormously stable and successful, this concept worked quite well. We currently have 24 physicians, all residency-trained and board-certified/eligible, who are all partners and equal shareholders. The group is completely democratic, with the most junior partner making the same salary and working the same shifts as the most senior partners. Administrative costs for the partners managing the group are capped at 4 percent of gross revenues. This year, the group will see about 100,000 patients with the aid of 15 advanced practice providers.

Since the group was started in 1985, we have had only one partner leave the group, and that was because his wife’s family, who lived nearby, moved. We only used locums once, 15 years ago, when the hospital asked that we immediately take over ED coverage for a smaller hospital it acquired. Within a year, they had all been replaced with residency-trained emergency physicians. Additionally, we have enjoyed a limited malpractice history. We have had very few claims because the physicians are good and known by our community. This has resulted in lower premiums.

Transitions are important. I recently retired from my clinical practice and administrative duties. The current leadership actively practices emergency medicine, and the group supports them. They are being creative and thoughtful as they handle the ever-increasing challenges of medicine. They implement important changes after the group votes while maintaining the core principles of the group.

The process can work. It works because the physicians come to work every day, making the process happen. They all believe that it is an honor and privilege to provide care for their community. I think that all the components (hospital, administration, community, and how the EM group is established) are important.

Dr. Fitzgerald is former CFO, past president, and founder of Carrollton Emergency Physicians in Carrollton, Georgia.