To say that emergency medicine is worried about corporate consolidation would be an understatement. The American Academy of Emergency Medicine and the American College of Emergency Physicians have written position statements, and many emergency physicians, prompted by Take Medicine Back, have recently lent their voices in anonymous statements and virtual appearances at a request. from the Department of Justice and the Federal Trade Commission for information on merger enforcement. (AAEM. April 12, 2021; https://bit.ly/32ZbwTb; CAPE. April 18, 2022; https://bit.ly/3Oa6TeS; https://www.takemedicineback.org; Federal Trade Commission; https://bit.ly/3xIQCqm; CAPE. https://bit.ly/3y7s8J1.)
Market consolidation harms workers through regional monopsonies, but labor market power is also affected by information asymmetry, that is, when employers, especially large ones, have more information about a labor market than employees. (U.S. Department of Treasury. March 7, 2022; https://bit.ly/3y6KXfl.)
A less competitive labor market stifles wage growth and reduces the quality of services provided. Improving access to information, which reduces information asymmetry, is an important way to challenge an increasingly consolidated marketplace, improving conditions for workers and consumers who, in this case, are doctors and patients.
We’ve built an app that collects anonymous reviews from emergency medicine employers and analyzes the results so doctors have as much information as possible. (https://www.takemedicineback.org/emrating.)
The app is free to use and all ER doctors and residents can leave a review and read reviews from others. It is completely anonymous, does not track IP addresses, and cannot identify users, so reviewers are protected.
Evaluators can answer a series of questions about employment in emergency medicine and enter comments. The questions are specific to participants and residents and they can search for employers or residences or add their own if theirs has not been entered.
Users can review the results and filter by employer (or location of residence) or employer type (or residence employment model). A net promoter score is calculated when enough data is available. Basic sentiment analysis is used to turn comments, which are not visible, into a sentiment score to let users get a sweeter idea of an employer.
The information is then fed into a Google Data Studio report that allows users to display geographic information and sort and filter the data based on characteristics. A resident, for example, could create a map of residences run by democratic groups, hospital workers, contract management groups, or any combination of the three.
Holding employers accountable
We can see some trends emerging from the 199 reviews available when this data was pulled on June 1. The vast majority of examiners so far are in attendance – 190 against nine residents.
A few job types dominate the reviews so far. (Chart 1.) Most reviews seem to come from four types of employers: contract management groups, democratic groups, hospital employees, and educational institutions. It is clear, even without doing a thorough analysis of the different types of employers, that contract management groups are viewed quite unfavorably compared to other employers. (Chart 2.)
However, this is an approximate summary of the data. The app itself gives a much more granular breakdown.
We would like to encourage all emergency physicians, residents and caregivers, to review their employer. The more data we share, the more likely we are to overcome our informational disadvantage in an increasingly consolidated market.
Not only is it our duty to hold our employers accountable, but providing information to another emergency physician may one day change where they work, where they live, and perhaps even the course of their lives. We all deserve to have access to the best information available when making such important decisions.
Dr. Belangeris secretary of the Locum Tenens chapter of the American College of Emergency Physicians and an emergency physician in McKinney, TX. Read his past articles onhttp://bit.ly/EMN-numbERs. Dr Liis the Chief Medical Officer of AAEM Locum Group, the founder of Thrive Direct Care, PLLC, and one of the founders of Take Medicine Back (https://takemedicineback.org). Follow him on Twitter@ApparentLiMDand@TakeMedBack.