1) does your group pay for rent in the ER?

2) how about the nursing staff – do your gross revenues get reduced by their salaries & benefits?

3) how about the electric bill and cleaning fees for the ER?

4) secretarial staff?

5) do you order (& pay for) supplies, or is that taken care of for you by the hospital?

NO, you work in a HOSPITAL, and as such have a steady stream of patients without the usual expenses & hassles of a private office (of which malpractice insurance is just a small part, for most small primary care offices).

And when you go home, you don't get paged after hours, in the middle of the night after working a long day, like your local primary care colleagues.

I agree that EMTALA is a load of crap. But don't confuse what YOU do with actually having the hassles of running a small business – something most small outpatient practices would gladly give up for the ability to just practice medicine.

EMTALA in no way mandates that the hospital subsidize the ER doctors.

Our group does pay about 15 dollars per uninsured patient visit for malpractice and billing.

Of course, if the ACEP thinks that primary care office should be mandated to see patients for free, that’s even nuttier than EMTALA. At least the ERs suffering EMTALA get a subsidy from the hospital profit centers. That would be the last straw for independent primary care practices.