The Rise of Standalone ERs Irks Doctors and Insurers

After developing a chest cold and breathing problems last year, Susan Alexander went to First Choice ER in League City, Tex., drawn by its motto, “Real ER. Real fast.” The 56-year-old nurse says her visit was speedy—about 20 minutes for a chest X-ray, steroids, and a breathing treatment. It was also expensive: about $2,000. After her insurance picked up its portion of the tab, Alexander had to pay $700. “I was astonished,” she says.

Once confined to rural areas without hospitals, free-standing ERs have been multiplying in suburbs for the last decade. Unlike urgent care centers, which are equipped to treat only non-critical ailments, these standalone ERs offer the same access to board-certified emergency-medicine specialists and complex technology found in a traditional ER. Some are owned by entrepreneurs, others by hospitals. Many have gourmet coffee, plush leather seating, free Wi-Fi, high-definition TVs, and something else that’s uncommon in a standard ER: little or no wait.