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The Need for Change
Two of our founders have spent decades within the healthcare system. R. Joe Ybarra, MD has over 25 years experience in emergency departments, and Pete Peters has spent his entire career as a practice administrator and healthcare executive.
Both Dr. Ybarra and Mr. Peters saw an opportunity for community-based free-standing emergency departments (FSEDs). They became convinced that FSEDs represented a critical next-step in the delivery of healthcare services. Dr. Ybarra was instrumental in the passage of the Texas House Bill 1357, which allows licensed, privately owned FSEDs to operate in the state of Texas.
The Emergence of FSEDs
As the FSED market developed in Texas, hospital-owned and corporate-owned FSEDs began to appear. These models offered patients and physicians an alternative to hospital-based emergency departments (EDs); however, neither model allowed for significant physician ownership.
Emergency medicine physicians who wanted to Own their Own ER™ faced significant hurdles:
- Large capital requirements to build and equip an FSED facility
- Significant licensing, compliance, and regulatory requirements
- The FSED model was new within the industry (the ecosystem of insurers and vendors needed to adapt)
Dr. Ybarra became an advocate for FSEDs within both the American Academy of Emergency Medicine (AAEM) and the American College of Emergency Physicians (ACEP). He authored position papers, delivered scientific papers, and advocated the formation of an FSED section within the American College of Emergency Physicians.
During this time, Mr. Peters served as a consultant to physicians who wanted to construct and licence their own FSEDs. His experience with these projects gave him direct experience with the processes necessary to successfully construct, license, and operate a privately-owned FSED.
Both Dr. Ybarra and Mr. Peters recognized the challenges that emergency medicine physicians faced when they wanted to go into private practice. They began to search for an option which would make the physician-owned FSED model more accessible.
The Franchise Model
In 2008, Dr. Ybarra and Mr. Peters turned their focus to physician-owned FSEDs, and they explored options which would allow the creation of a scalable ED system which would provide an ownership option for experienced emergency medicine physicians.
Dr. Ybarra and Mr. Peters partnered with Mr. Cereso, a Nevada franchise attorney and Mr. Sherman, an operations consultant specializing in personnel and processes.
They quickly recognized that the franchising model allows the best formula for creating a national network and consistent brand while also giving physicians the autonomy to care for their patients. The franchising model made it easier for experienced physicians to become physician owners.
For the past four years, these four founding partners have been building the infrastructure necessary to support the ConciER™ FSED franchise network:
- Developing custom processes and refining models necessary for the operation of the FSED network
- Negotiating relationships with corporate partners who will assist our franchisees
- Recruiting team members with the professional skills necessary to support a high-growth franchise organization
The partners also spoke with many emergency medicine physicians to understand their needs and refine the model. In 2010, they attended and exhibited at AAEM in Las Vegas, and in 2011, they attended TCEP in Galveston.
The ConciER™ FSED Network
The ConciER FSED Network was formed in early January 2012, and it debuted in April at the annual meeting of the Texas College of Emergency Physicians (TCEP).
As a franchise network, ConciER commits itself to community-based FSEDs owned and operated by experienced emergency medicine physicians.