Fallon ER facilitator program: managed care in the ER setting.

Managed care systems have traditionally found ER management issues difficult to address. Patients view these facilities as points of consistent, easy, and reliable care. Providers see these facilities as necessary off load points from busy practices for problems whose intensity or complexity would overwhelm their office work flow. Emergency Department physicians understand their roles as nondiscriminate passive recipients of all patient flow through their facilities. These same providers also recognize a huge liability potential for both missed diagnosis and for perceived inadequate/unsafe treatment plans such as non-hospitalization when hospitalization was needed.