Unlike any other physicians, emergency physicians do not determine, nor control, the number of patients who present for treatment. In fact, patients who may be turned away from office-based practices are frequently directed to emergency departments for care. As a direct result of both federal mandates and patients turned away from physician's offices for lack of funds, a substantial number of services provided by emergency physicians are never reimbursed. A very high percentage of uncompensated care is therefore created. While the American College of Emergency Physicians acknowledges that other specialties also incur the costs of uncompensated care.
Uncompensated care includes both bad debt and charity care.
The Lewin group, a respected research consulting group in Washington D.C., performed an extensive research study to determine the extent of this uncompensated care in the emergency setting. The uncompensated care data in the study is mostly representative of bad debt since true charity care, care provided without bill submission, is really provided in an emergency department setting. Emergency physicians, like other physicians, have office personnel to help manage financial aspects of the business. Attorneys and accountants are necessary in addition to business managers who help coordinate the practice. The typical office equipment in addition to office lease are standard expenses.