Freestanding ER versus Hospital ER – What’s the Difference?

When you have a sudden chest pain, a serious illness or injury, or any type of medical emergency, you have two options for emergency treatment--a hospital emergency room (ER) or a freestanding emergency room (FSER). Though there are differences between the two, Orlando Health ERs and FSERs offer the same level of emergency care.

Hospital emergency rooms are more commonly known – they’re usually physically connected to a hospital building, perhaps with an individual wing. Freestanding emergency rooms (FSERs) present another option for medical care, and they are becoming increasingly popular across the country.

FSERs are not located in hospitals—they are standalone buildings, but may be located in convenient areas of a community—much like urgent care centers. But unlike urgent care centers, which have limited capabilities, FSERs are more similar to hospital ERs. FSERs operate 24/7 with access to emergency physicians, emergency nurses, and laboratory and radiology technicians who can do complex blood testing and advanced imaging capabilities, such as ultrasound and computed tomography.

Is There a Difference Between an ER and a FSER?

ERs are designed to handle life-threatening illnesses, conditions or injuries. FSERs are designed to perform the same way, but because they are located more conveniently in communities,  they’re easier to access and there are more of them, they may have shorter wait times.

If you have trouble breathing, chest pain, a sudden mind-numbing headache, weakness or numbness on one side of the body, heavy bleeding, a deep wound or a serious burn injury, it’s best to get medical attention immediately, either via an emergency room or FSER. If you feel your life is at risk, or if you’ve experienced a serious trauma like a car accident or fall that may lead to permanent disability, call 911 so an ambulance can transport you, most likely to the closest ER or the best choice hospital for your suspected medical condition (i.e. trauma center, stroke center). In addition to taking you to the hospital’s emergency room, first responder personnel can begin life-saving treatment as soon as they reach you, versus waiting until you’ve arrived at the hospital to start assessing and providing treatment.

Understanding more about a FSER can be helpful in deciding where to go:

• Wait times can vary between emergency rooms and FSERs. All emergency rooms have a standard protocol for evaluating the urgency of each patient's condition and allocating resources accordingly, so those with the greatest need are seen first. Wait times for FSERs also may fluctuate, but their multiple convenient locations can be a benefit since the patients may be more dispersed across the area, so ultimately, the wait time can be shorter.
• At Orlando Health, FSERs operate on a similar cost structure as hospital-based ERs. Not only are they both required to provide treatment regardless of ability to pay, but they take the same insurance and charge the same amount. In a medical emergency, don’t let concern over payment make you delay needed treatment. Orlando Health FSERs operate under the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospital emergency rooms to provide emergency services to those in need, regardless of ability to pay or insurance coverage.
• If you are being treated in a FSER and your medical situation requires more advanced lifesaving care, or you need to be admitted for inpatient care, you will be transported by air or via ambulance to the most appropriate hospital to meet your needs. If you’re in a hospital-based ER, you could still be transferred or admitted to the attached hospital based on your needs.

The Orlando Health Advantage

At Orlando Health, all of our FSERs and hospital-based ERs are staffed by the same emergency medical group, including the trauma centers at Orlando Health Orlando Regional Medical Center and Orlando Health Arnold Palmer Hospital for Children. That means all our locations have board certified emergency medicine physicians. Not all urgent care centers or ERs offer that expertise.

Regardless of whether you go to an ER or FSER in an emergency, these centers aren’t a substitute for regular doctor’s visits and shouldn’t be used for primary care. Instead, they can bridge the gap when your condition or injury requires immediate and urgent attention. Even if you get emergency medical treatment, it is a good idea to schedule a follow-up visit with your doctor. That way, you know you’re getting the best and most comprehensive care possible.