FSED downtrend in Texas

[Baggend]

I have noticed a downtrend in FSED facilities in my region - Dallas-Fort Worth. Is this the same elsewhere in the country?

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[It's lupus!]

I have noticed a downtrend in FSED facilities in my region - Dallas-Fort Worth. Is this the same elsewhere in the country?

There weren't that many stood up in DFW in the first place though, I say that by only observation myself. Hahs

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[deleted109597]

I have noticed a downtrend in FSED facilities in my region - Dallas-Fort Worth. Is this the same elsewhere in the country?

FSEDs aren't common over most of the country anyway. But yes, the FSED boom has subsided, and like Coffee Shops and alcoholic painting stores, there's only so much the market can handle.

 

[The White Coat Investor]

I went to the FSED section meeting at ACEP last year. It was a dramatically different tone than in prior years. Kind of depressing really.

 

[emergentmd]

This is like any other business and market forces will make the well run sites thrive and the poor ones fail.

I am fine with this as there are way too many FSERs and some people have business opening one.

 

[GLIPGLOP]

Seems like everything in texas is drying up in the major cities... not as lucrative as it once was unless you came into the market early

 

[deleted109597]

Seems like everything in texas is drying up in the major cities... not as lucrative as it once was unless you came into the market early

There are plenty of underserved areas though. If CMS would recognize them some of the issues in rural communities could be solved. But you can't decry them for "not taking Medicare" or opening in lower income areas and at the same time not legally allow them to participate.

 

[bikERdoc]

Starting to feel the contraction in Colorado too. FSEDs have been one of the worst factors in our market I've ever seen. First, they created a ton of EM jobs in a traditionally difficult place to find EM work. Now, I'm seeing young docs getting screwed because business didn't go to plan. Colleagues who have bought houses here and settled in are being forced to look at locums and firefighter positions.

I'd be very wary of joining any group right now that is heavily invested in the FSED model. Many are not thriving depending on the location and local market.

 

[The White Coat Investor]

Nobody in Denver or SLC is looking at the FSEDs in our markets as a good thing. More like our cross to bear.

 

[sum dude]

If you don't work in TX/CO/LA, they are a huge money loser for groups. Multiple ones opening up here in FL, for some reason the competing hospitals like opening them up next to each other. They see low volume/acuity, low numbers. It's an easy place to work, but if you don't get the facility fee, they are big time money losers to staff w/ physicians. The one plus is that they're pretty easy to work at. I have no idea how CMG's are paying $220/hr to staff these things--they are definitely losing in millions at that rate.

In TX, the free-market won out, w/ multiple groups flooding the supply in big cities. With a flood in supply, the competition was too much, and late-comers/less financially secure groups lost out. Groups got greedy, and now the honey pot is gone. They can save the whole "underserved" area--I've never seen a FSED open up in an underserved area. They are always in the nice suburb, trying to steal marketshare of insured patients from the established hospital-based ED in the area.