Core Principles

  • 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.

  • 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.

  • 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.

  • 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).

  • 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.

  • 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. Though challenging in the current health-care arena, Mercision strives to partner with hospitals or entities that are not affiliated with these financial institutions.

  • 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. We conduct follow-up calls with higher risk patients discharged patients to ensure no changes in clinical status and that primary care or specialty follow-up is achieved.

  • 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.

  • 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 as contractors. All physicians under the Mercision umbrella 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.

  • Fees

    Mercision is not an agency, nor has any dire to be one. We are simply Emergency physicians passionate about our own agency, self-worth, and ability to deliver precision care under our own standards, ignoring systems that often work to suppress that. Our physicians are incentivized with above-market rates, our clients are billed far-below agency standards, and thus our partnerships remain robust to hold superior patient care to the underserved.