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Independence
We do not have an affiliation with any client we serve, and by maintaining a locums status at
multiple institutions we operate freely, independently, and always with the interest of the patient first.
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Metrics
We uphold the AAEM standard that for a comprehensive, moderate acuity emergency department, the emergency physician staffing ratio
should be based on the rate of patient influx such that the rate of 1.5 patients per physician per hour is not exceeded. Metrics however
can create ethical grey-zones and often unsafe practice environments. We strive to operate at a pace that ensures thoroughness while
upholding patient safety and strong documentation.
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Patient Satisfaction
Press-Ganey has been an unfortunate addition to the practice of medicine, and the most recent studies confirm
we are harming patients by attempting to attain high patient-satisfaction scores. We strive - with survey criteria in mind
- to be professional, compassionate, and achieve superior bedside manner to all our patients, but this is done within the
scope of ensuring the best interests of the patient are met first.
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RVU and Reimbursement for ER Physicians
Reimbursement schemes that have been employed by large staffing corporations create ethical
quandaries that can be at conflict with the best interest of the patient. We are compensated hourly for
our work, and not “incentivized” by an RVU pay structure (in which a physician is paid in excess of
their base hourly rate for their productivity).
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Billing
As an independent practice, we uphold vigorous standards to ensure billing is accurate and an honest reflection
of our encounter with the patient. This generally pertains to not "signing off" on the charts of patients we did
not see or adding “critical care time” for charts in which no such time was engaged. Mercision ends relationships
with clients that do not uphold our billing principals.
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Affiliations
Large staffing corporations create ethical conflicts regarding patient care and safety when they are associated
with private equity firms, as these latter institutions are exclusively business-focused and profit-driven.
We do not contract with any hospital or entity that is affiliated with, owned, or controlled by these financial institutions.
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Patient Follow-Up and Breaking the Mold
As an independent locums practice, we provide patients with a 24-hour direct contact line for any
questions about their care, or discuss ER return precautions. We offer facetime to our patients in
this setting so we may decide if this patient needs to be reevaluated back in the ER. Our staff is
active in follow-up phone calls we review weekly for discharged patients during staff meetings.
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Safe Work Environment
As administration is constantly changing hands in hospitals and staffing corporations are vying
for contracts, staffing patterns are in flux at hospitals. With inappropriate coverage (specifically
at peak hours), improper use of nurse practitioners and physician assistants, and stretching EM physicians
beyond their capacity, unsafe work environments are born. By having our clients adhere to our "safety contract,"
Mercision Emergency Medicine ensures that unsafe conditions that may arise are promptly addressed.
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Partnerships
Through word-of-mouth referrals we obtain contracts in excess of what we can cover. For that reason, we link our
physician partners to our contracts to work alongside us. All partners within Mercision are invited to join rather
than recruited based on direct observation of their clinical skills in the Emergency Department, bringing a quality
standard to our clients that most agencies are unable to offer. Mercision was born with the guidance of locums
agencies, and we retain two within our practice because of the tremendously positive experiences we have had with them.