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Emergency rooms compete for customers

Big advertising money is following new health care facilities and services in Snohomish County.

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  • Providence Regional Medical Center Everett is spending about $150,000 on an advertising campaign involving print, radio and direct mail to educate the...

    Providence Regional Medical Center Everett is spending about $150,000 on an advertising campaign involving print, radio and direct mail to educate the community about what a marketing director calls "the different types of emergency room care."

  • Providence Regional Medical Center Everett is spending about $150,000 on an advertising campaign involving print, radio and direct mail to educate the...

    Providence Regional Medical Center Everett is spending about $150,000 on an advertising campaign involving print, radio and direct mail to educate the community about emergency room care.

  • Seattle's Swedish Health Services has launched a $100,000 advertising campaign that includes cable TV, newspaper ads, the Internet and mailings to hom...

    Seattle's Swedish Health Services has launched a $100,000 advertising campaign that includes cable TV, newspaper ads, the Internet and mailings to homes in the Mill Creek area to promote its new satellite emergency room, which opens Thursday.

Snohomish County is fast becoming one of the most competitive health care markets in Washington.
Medical groups are spending millions on new buildings and services to try to woo you as a customer.
The battle currently has two large health-care organizations, Providence Regional Medical Center Everett and Seattle-based Swedish Health Services, participating in an advertising blitz focusing on their new emergency rooms.
Combined, the two organizations are spending an estimated $250,000 to promote what they see as the qualities that will make you come to them during an emergency.
Swedish is trumpeting its new satellite emergency room, part of a $30 million medical building, which opens Thursday in south Everett. It expects to treat 20,000 patients this year at the satellite emergency room, which means there's no hospital on site.
In its ads, Swedish is promoting its location -- near the 128th Street SW exit on I-5 in south Everett -- and promises "no-wait" service.
Providence, opening a new $460 million medical tower in June, and an emergency room that will take up its entire first floor, isn't waiting to publicize what it sees as its advantages.
Its ads promote its award-winning emergency room service and ask: "If you need an emergency room, wouldn't you rather there be a hospital attached?"
Meanwhile, walk-in clinics, both locally and nationally, aren't about to be left standing on the sidelines.
The Everett Clinic, which operates eight walk-in facilities that treat some 165,000 patients annually, plans to compete by shortening wait times and is considering adding staff. It posts its walk-in wait times on its website.
The website also lists problems, such as cuts, sprains and allergies, which can be treated at walk-in clinics, and those that should be treated in emergency rooms, like chest pain.
Providence's roots in Snohomish County date back more than a century. Last year, its emergency room was one of the busiest in the state, treating 110,500 patients.
"We've earned the community's trust for emergency room care," said Dave Brooks, the hospital's chief executive.
Swedish, which celebrated its 100th anniversary last year, has three hospitals in Seattle.
It has taken several recent steps to expand its patient base in Snohomish County. Last year, it took over management of what formerly was called Stevens Hospital in Edmonds, now Swedish/Edmonds.
Swedish/Mill Creek is the third satellite emergency room it has opened since 2005, and the first outside King County.
These moves into Snohomish County are part of a strategy to reach out beyond its traditional urban King County base to new, growing suburban markets.
The two health care organizations offer different types of emergency room services.
Providence's emergency room is based at its hospital, which has a wider variety of specialty and diagnostic services. Its ad campaign is trying to hone in on this point.
"Consumers didn't understand there were different types of emergency rooms," said Teresa Wenta, marketing director.
Providence officials say they take pride in the hospital's nationally recognized cardiac services, immediately available to patients who come to its emergency room.
Chest pain can indicate either serious heartburn or a serious heart attack, Wenta said.
"We want consumers to understand there may be differences in services available to them" based on what choice they make about where they seek emergency care, she said.
Swedish, on the other hand, is hoping to capture the estimated 60 percent of emergency room patients who need quick medical attention, such as for a cut or broken bone, but generally don't need further medical treatment.
Based on the experience at its Issaquah satellite emergency room, which opened in 2005, only about 7 percent of patients need to be transferred to hospitals, said Dr. John Milne, who oversees Swedish's three satellite emergency rooms.
The in-and-out times for patients treated at the satellite emergency rooms average about 80 minutes, which can be far shorter than in hospital emergency rooms.
Which is better for consumers? It depends on what type of medical problem needs to be treated.
An agreement already has been reached in Snohomish County to avoid confusion on where to take ambulance patients, Milne said.
Patients whose heart rhythms indicate they may be having a heart attack or people who have suffered major trauma injuries in auto or work site accidents will be transported directly to hospital emergency rooms, he said.
Why all this attention to emergency rooms?
It's a way to make an impression -- a good one if treatment is both speedy and good -- on the quality of health care the organization can provide.
In short, it's one step in winning customer loyalty.
The emergency room also serves a key role in filling hospital beds. Nearly half of all patients admitted to Providence Regional Medical Center Everett were first treated in its emergency room.
Olympia may be wading into the fray over stand-alone emergency rooms, which don't have to undergo the time-consuming and expensive process of getting state approval, as new hospitals do.
It took nine months for Providence to get state approval to build its new medical tower, said hospital spokeswoman Cheri Russum.
State Sen. Cheryl Pflug, R-Maple Valley, has introduced legislation calling for a moratorium on construction of new satellite emergency rooms until July 2013 to allow the state Department of Health to study their impact.
It also would require the parent organization of freestanding emergency rooms to pay the costs of transporting patients to hospitals when further treatment is needed.
"We don't necessarily feel there is a need for a moratorium," said Milne, who oversees Swedish's satellite emergency rooms.
"We feel … these types of facilities are a huge benefit to the communities in terms of improving access to care."
Patients will benefit from the growing competition for their business, said Rick Cooper, chief executive of The Everett Clinic.
"It causes all of us to sharpen our edge on customer service," he said.
It also will likely mean that consumers will have more comparative information on the costs of getting medical care, Cooper said.
One example is a battle for patients now playing out in King County.
Bellevue's Overlake Hospital Medical Center has launched an advertising campaign plainly stating that services like sprained ankles can be treated just as well at its urgent care clinic in Issaquah as an unnamed "standalone emergency room" -- and for $245 less.
Swedish operates a nearby satellite emergency room.
"Freestanding emergency rooms tend to be significantly more expensive than urgent care centers," said Caitlin Hillary Moulding, Overlake's vice president for marketing.
Swedish officials don't deny that their charges are similar to those at hospital-based emergency rooms. Current pricing structures don't allow them to charge different prices, Milne said
But they also offer many of the high-quality services that can be provided in hospital emergency rooms, he said, both through the training levels of their staff and their equipment.
"These facilities are not built as a stripped-down emergency room," Milne said.
The lesson for cost-conscious consumers is to make good choices on where they need to go to get medical care, said Cooper, of The Everett Clinic. Otherwise, they could end up paying more out of pocket than they need to.
"I think informed consumers need to know what is an appropriate condition to be seen in a walk-in clinic versus an emergency room," he said.
Alice Cabe, a board member of Valley General Hospital in Monroe, questioned whether competition provides the same consumer benefits in medical care that it does in other types of businesses.
Health care premiums continue to go up, sometimes at double-digit rates, she said.
"What they'll say is that competition drives up quality, too," she said. "Does competition drive health care costs down? Probably not.
"I don't know that competition in medicine produces the same economic results as it does in the big-box stores," Cabe said.
Sharon Salyer: 425-339-3486 or

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