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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

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    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

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When an ER – Is Not an Emergency Room

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About “InQuickER”

[By Dr. David E. Marcinko; MBA, CMP™]

[By Prof. Hope Rachel Hetico; RN, MHA, CMP™]dave-and-hope

Visits to emergency rooms climbed to a record high of 119.2 million in 2006, up from 115 million in 2005; with an average of 227 visits per minute, according to a new report from the Centers for Disease Control and Prevention [CDC]. So, it’s not surprising that InQuickER” is a new service of Emory-Adventist Hospital [EAH] in Smyrna, Georgia.

How it Works

According to the hospital’s website, patient may schedule his or her trip to the emergency room through an open access process that takes three steps.

1. Reserve an appointment time through the InQuickER website when emergency care for a non-life-threatening issue exists. The site shows the soonest possible time to be seen. You can either reserve that time or choose another time more convenient for you; up to 6 hours later than the first available time. All you need do is briefly describe the injury or illness, and the ER will waiting for you to arrive.

2. Time is saved by filling-out an online registration with medical history that includes allergies and current medications. This allows patient’s to bypass front-desk registration and go straight to a ready and waiting treatment room upon arriving.

3. A printable appointment confirmation slip, with driving directions, completes the online transaction.  

Guaranteed or it’s Free

Be seen in 15 minutes or less — or you don’t pay!

The cost for this premium service is $24.99. Of course, regular charges for diagnosis, treatment, consultants and admission may still apply. Online visitors are admonished to visit the website for additional terms and conditions.

The SIMPLE Button

The average time spent waiting for treatment in an emergency room in a United States is 3.2 hours. So, EAH wants to make life easier by allowing patients to wait in the comfort of their own homes. According to EAH, it’s really that simple.

But, is it really as easy as the SIMPLE button of retail giant, Staples, might suggest? Or, is this an economic operating-room, in-patient, or out-patient-poaching tactic?

Three Key Points

1. Patients don’t always know whether their conditions constitute an emergency.

2. What’s the optimal rate of “inappropriate” ER visits as the surgical analogy of appendicitis comes quickly to mind.

3. How harmful are inappropriate ER visits, as opposed to ER closure due to unfunded EMTALA or other initiatives?

Open-Access Scheduling

The concept of open-access scheduling is not new, and should be embraced more than it is by the medical community. Many feel the public is clamoring for it. But, is it appropriate for emergency room use? Or, is this an artifice just a clocked marketing gimmick.

And, what new term shall we give to “real emergency rooms?” Can the public even marginally discern the term’s meaning,  given the gross abuse of other potentially life saving healthcare mechanisms like 911 calls; as demonstrated by one Reginald Peterson, of Florida, who called the service – twice – because his spicy Italian Subway® sandwich was missing its sauce?

One also wonders how local hospital staff members, and surrounding primary care doctors, internists and related front line practitioners; as well as walk-in and retail-clinics feel about this service; competitive threat or community boon? Is the idea of a non-emergent – emergency – an oxy-moron; muck like the term “jumbo-shrimp”?

Patient Computer Access?

Do the usual homeless, tired, hungry and mentally deranged patients typically seen in inner city ERs have computer access, or “homes to wait in comfort?”

And, wasn’t the managed care revolution, with its no and low-cost copays supposed to put an end to “ER-squatters?”


We believe this business strategy will work because of its affluent location, in North-West Atlanta. It will save the ER money and earn income for the hospital. Suburban patients and soccer moms will also love it. But, as young students, we worked in the ER admissions departments of the old Cook County Hospital in Chicago; and Pennsylvania Hospital on Pine Street in Center-City Philadelphia [City of Brotherly Love]. And, we don’t think the scheduling concept would work there; then or now; nor here at Grady Memorial Hospital in Atlanta. Please opine and comment.  


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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12 Responses

  1. It’s Defensive Medicine, that’s Why!

    ‘Defensive medicine’ adds to health care costs, and risks to patients, according to Benjamin Brewer MD, a family physician who writes a column for The Wall Street Journal’s Web site.

    He describes the practice as “doing more tests, ordering more consults from specialists and exposing patients to the risks of radiation, invasive tests and treatments” to protect the practice from being sued.

    Now, does this definition include sending patients to the ER?



  2. Liberal ER Visits,

    In the old-days, when a patient called the family doctor about a seemingly innocuous complaint, s/he usually said: “Take two aspirins and call me in the morning”.

    Today, it’s more like: “Call 911, or go directly to the ER.”
    That’s why!



  3. Microsoft to the ER Rescue

    The Microsoft Corporation, based in Redmond WA, has contracted with Seattle-based Carena to handle physician house calls for the company’s employees. Carena’s Urgent Care program is intended to reduce costly trips to the ER for injuries or illnesses that could instead be treated by as visiting physician.



  4. Post ER Visit Compliance Report

    Did you know that a vast majority of emergency room [ER] patients are discharged without understanding the treatment they received or how to care for themselves once they get home, according to a study published by the Annals of Emergency Medicine?

    Researchers followed 140 English-speaking patients discharged from emergency departments in two Michigan hospitals and measured their understanding in four areas: their diagnosis, their E.R. treatment, instructions for their at-home care and warning signs of when to return to the hospital, according to the New York Times on September 16th.

    Seventy-eight percent of patients did not understand at least one area and about half did not understand two or more areas, while the greatest confusion surrounded home care – instructions about things like medications, rest, wound care and when to have a follow-up visit with a doctor. Researchers said the confusion can lead to medication errors and serious complications that can send them right back to the hospital.



  5. Inflated ER Wait Times

    Did you know that inflating estimated emergency room wait-time makes patients happier, according to a study presented at the American College of Emergency Physicians [ACEP] meeting in Chicago.

    As reported by the Wall Street Journal, October 30, researchers calculated the mean time it took to get through the ER for a given test or procedure, then added 20 percent when they told patients what to expect.

    In a standard patient satisfaction survey, all nine variables related to wait times improved after the ER adopted this policy, while the improvement was statistically significant for five of the variables.

    Isn’t this same ploy used by restaurants?


  6. Iasis Health Care in Arizona

    Now posts ED wait times, for the system’s three hospitals, online.




  7. Is Posting ER Times a Gimmick?
    [A Related Follow-Up Story]


    Hope Hetico RN MHA
    [Managing Editor]


  8. Posting ER Waiting Room Times?

    When patients in the emergency room arrive by helicopter or ambulance and are seen immediately; average wait times are driven down.

    This highlights a concern with hospitals posting wait times on billboards and websites because the times might not always reflect reality. And, in emergent-care situations, longer-than-expected wait times could pose major health risks to patients.




  9. That bites! Dental patients in ERs on the rise

    According to an essay by Karen M. Cheung, new research by Pew confirms what many providers have feared: More Americans are going to the emergency department for routine dental problems, such as toothaches.

    Click to access A%20Costly%20Dental%20Destination.pdf



  10. Project reduces ED use for non-emergency conditions

    Dr. Marcinko – A project from the New Jersey Hospital Association concludes that more than one-third of ED use in the Garden State is for non-emergency primary care conditions that could be treated more appropriately — and more affordably — in a doctor’s office or retial clinic.




  11. More on the ED

    Dr. Marcinko – Does texting ER wait times affect patient care?


    Any thoughts?



  12. Latest Trend in Medical Convenience

    ER appointments not an exactly new, or novel, idea for the ME-P.




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