This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of the nation's largest contract management groups, held the contract for the emergency department at HolyCare Hospital. The company managed the scheduling, billing, and workflow of the emergency medicine physicians, who were technically “independent contractors” with the company. It also provided them with medical malpractice insurance and helped them minimize legal risk. The chapter considers the billing practices of HolyCare doctors and the effects of physicians' individualism on the quality of care at HolyCare. It shows that entrepreneurship was structured within larger organizations (from the physicians' group to the hospital itself) that also profited from doctors' profiteering.
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