Texas begins regulating freestanding ERs

HOUSTON "Hospital ERs are overburdened," said Dr. James Jackson, who owns Clear Lake ER. "When you go there, it's a long wait, sometimes unpleasant."

Clear Lake ER is a freestanding emergency clinic. Dr. Jackson's clinic boasts six patient rooms, a CT scanner, x-ray machine, a pharmacy and its own lab.

"We can lab tests back in as little as a minute," Dr. Jackson said.

But as more and more popped up, not all freestanding emergency rooms were the same in terms of how and when they treated patients in emergencies. That's why the state of Texas, as of this fall, is now regulating the clinics.

"Good patient care is delivered in a regulated environment," said Dr. Tim Seay with the Greater Houston Emergency Physicians.

Seay is a physician who owns a freestanding emergency clinic. He was part of the move to regulate the burgeoning industry so that people in need of emergency care know what to expect when they need help.

"The regulations address every single aspect of the building, of the floors, of the walls, of the sanitation, infection control, clinical services, what kind of doctors are there," Dr. Seay said.

Here's what you should know before you're in the middle of an emergency:

• Is the clinic open 24 hours?
• Does it have an agreement with a hospital for transport if you need it?
• Does it accept Medicare or Medicaid?
• Also, make sure it is not an urgent care clinic.

"There is some confusion out there among the public about what is the difference between an after-hours clinic, an urgent care clinic and a true freestanding emergency room," said Dr. John Zerwas, who also is a member of the Texas House of Representatives.

Urgent care clinics are not held to the new regulations. They are not subject to oversight by the Department of State Health Services as are freestanding ERs effective September 1.

"It's very difficult to meet all of the state's requirements," Dr. Jackson said.

Dr. Jackson knows those regulations well. Clear Lake ER was the first in Texas to earn the new license, one that every freestanding ER in the state must get, not only to ease the burden on traditional emergency rooms but to ease the concerns of patients who go to them for help.

Urgent care clinics are not for emergencies. Instead, think of them as after-hours doctors' offices.

As for freestanding emergency clinics, even with the new state regulations, it's best to do your homework before you need them.