Some physicians saddle large CMGs with a great deal of negative baggage. Though some CMGs deserve a little criticism, it is inappropriate to categorize all EM groups similarly. With an extremely wide variety of possible group situations, each group must be evaluated individually to provide a true assessment. Group size should not form the sole basis of a career decision. Some of the advantages of good multi-site groups include economy of scale and reproducing successful ideas at multiple sites.
Some negatives come into play when quality is compromised for the sake of the almighty dollar.
Groups that are truly committed to quality never lose sight of the potential negatives and continually work to eliminate them. EM is stressful in the clinical hours. Taking on the added stress of the operations of the business should be carefully considered. Medicine has become more of a business over the last ten years, and it is more and more difficult to succeed unless the business of medicine is appropriately addressed. Issues such as billing, benefits management, risk management, accounting, customer service, and physician services can potentially overload a single hospital group.