As a new independent group, we learned about the business of emergency medicine and the art of negotiations. We are a much more lean and efficient organization than when we were under a large group. We have no recruiters, regional directors, or layers of management. Being cost-conscious is crucial, as we have a very poor payer mix and resist taking hospital stipends. Our expenses are minimal, and our provider salaries are not considered a line-item expense but group profit. We know that no one cares more about our money than we do.

We do not have service lines and official vertical integration like large groups have, but we have the best working relationship with our hospitalists and specialists. In the middle of the night, I can call Seth, my trauma surgeon, and Mark, my urologist, for a dual consultation for possible Fournier gangrene and have the patient in the operating room within an hour. I think an important indicator of quality medical care is collaboration of the medical professionals. Unfortunately, there is no Centers for Medicare & Medicaid Services measure for that.

We are forever grateful to our administration that gave us the opportunity to create our group and makes it a point to respond quickly to various requests from the hospital or medical staff, as they are not just business collaborators but friends.

My physicians still hold resentment to the large group we broke off from. The experience was like going through a divorce, and their blood would boil at a suggestion of joining a large group again. Yet there was something about the large group that I missed. I enjoyed the collaboration between emergency physicians from different hospitals. If only independent emergency physicians could get together, then we would have the best of both worlds, small group independence plus large group collaboration. Emergency groups are resistant to sharing anything with one another due to competition and fear of “stealing” contracts. That’s how the idea for Independent Emergency Physicians Consortium (IEPC) was born.

IEPC was established in 2012 and brings stability and support to more than 30 emergency departments in California. IEPC assists independent emergency physicians with sharing best clinical and business practices, annual surveys, marketing, recruitment, producing individual ED annual reports, human resources information, confidential consultation from hired hospital administrator and collective shared expertise. Our members believe in preserving their independent status and sign strong nondisclosure agreements that allow for trust in sharing sensitive business and clinical data. IEPC does not do any individual group management. Each group preserves its own billing, malpractice, pay model, and culture.