Business-centric Healthcare's Effects on the Doctor-Patient Relationship in the Emergency Department

The doctor-patient relationship has always been at the core of health care, and this relationship remains of paramount importance, regardless of treatment location or the patient's condition. The hospital emergency department (ED) plays a major role in this relationship by providing access to board-certified, residency-trained emergency physicians capable of rapid diagnosis and treatment of urgent, emergent, and life-threatening conditions. U.S. EDs also serve as the nation's safety net for the care of uninsured and underinsured patients. As the ED has become a major profit center in the multi-trillion-dollar health care industry, business-centric pressures on ED care pose major threats to the doctor-patient relationship. This article describes and evaluates business-imposed practices that can undermine this relationship in the ED. Health systems should strive to enhance relationships between emergency physicians and their patients and to avoid business practices that undermine them.