Okay, that's a little dramatic, but only a little. Back to your local hospital we go. Those chili cheese fries and beer chaser didn't sit to well and you aren't quite sure if it's heartburn or a heart attack you are currently experiencing. You take the fastest known route to direct provider medical care possible, the Emergency Room.

4 hours later when you are finally seen by a doctor and not feeling quite as badly as when you walked in, diagnosis heartburn. Lay off the chili, cheese and the fries, tubby!

In the mail the next month is a bill, of course. Not, however, from "the Local Hospital," but, instead from "ER Doctors & Friends, Inc." Wait, who they? They, as it turns out are the large corporation that has secretly taken over your hospital's ER staffing. Re-wind. It is 2009. Medicine is a business. One with a surprisingly small profit margins, particularly in hospitals. So how does every other American business increase profit margins? Out sourcing! That's correct. Chances are the doctors in the ER of your local hospital are contract employees. Which is good right?

Maybe. But what if the regionally distant corporation that owns "ER Doctors & Friends, Inc." does not have high standards for it's employees? What if it is cheaper for them to employ doctors who are not Board Certified (more on that to follow in the future)? What if it's cheaper to employ the "C" students and not the "A" students? What if it's cheaper to employ doctors who did not perform a specific internship or residency in Emergency Medicine? What it it's cheaper to employ doctors who have racked up multiple, and deserved, medical malpractice law suits? "Hey, lay off the docs, you lawyer," you say? Fine.

What if the corporation itself has no policies and procedures for it's contract employees to follow? What if your local hospital only "supervises" those providing care in the ER in the vaguest use of the word?

How comfortable are you now going home with that heartburn diagnosis?