An emergency physician says he believes at least half, if not more, of the free-standing ERs may be forced to close due to decreased volume because of COVID-19.

AUSTIN, Texas — Dr. Stephen Van Roekel said while most people may believe emergency rooms are busier than ever, many may be forced to shut down due to decreased volume of patients because of COVID-19.

Van Roekel is a part-owner and operator of Express Emergency Room on Riverside Drive. He's also an emergency physician there.

"I’ve got 20 years of experience," said Van Roekel. "I did the first 11 years in the hospital emergency departments and I’ve done the last 10, going on 11, years solely in the free-standing emergency centers."

He said there are about 200 free-standing ERs in Texas and said the volume of patients has gone down by around 40% to 60%.

"Because of the volume reduction, they are literally threatening small hospital closures, and the free-standing emergency centers, which there are 200 of. I would not be surprised if this goes on for several more months, over 50% of them could close," he said.

Van Roekel also said he's talked with emergency physicians across Texas who are facing hour reductions and layoffs right now because of a lack of patients.

"Despite risking their lives every day going to work, they are taking massive layoffs and hour reductions across the board," he said, explaining this is happening at bot free-standing and hospital ERs.

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KVUE reached out to Ascension Seton, Baylor Scott & White and St. David's HealthCare to see if any of their staff are facing hour cuts or layoffs.

Ascension said Ascension Texas, which includes Ascension Seton and Ascension Waco, has not made any COVID-19 related cuts to Ascension Seton employed healthcare staff. It also said it is protecting employee pay and offering financial support to employees.

"In these incredibly challenging and unprecedented times during the COVID-19 pandemic, we stand together as one Ascension to help our associates in need in as many ways as possible, including offering financial support," said Andy Davis, president and CEO of Ascension Texas. "From frontline staff at our sites of care to administrators and support staff, we are committed to taking care of all of our associates so they can take care of our local communities."

Ascension Seton said it is providing financial assistance for emergency dependent care to ensure that any associates who may be facing unexpected financial hardship have access to affordable, dependent care services during COVID-19. It also established a financial hardship program to provide emergency assistance to staff for essential services.

Baylor Scott & White issued this statement:

"We are committed to reducing some of the uncertainty around our employees’ financial well-being by committing to protect everyone’s pay through May 31. All team members, including our physicians and APPs, will have this protection even if temporarily assigned to a different job in the organization. This commitment assumes all team members continue to work together, stay flexible and agree to help out in ways that make sense based on training and experience."

St. David's HealthCare said it has experienced a decrease in surgery and outpatient volume as a result of COVID-19, "leading to a reduction of hours for many of its colleagues."

HCA Healthcare, the managing partner of St. David’s HealthCare, announced a new “pandemic pay continuation” policy which applies to all St. David’s HealthCare employees.

“This pandemic is unique, and our colleagues’ concerns are real,” David Huffstutler, president and CEO of St. David’s HealthCare, said. “We want them to know that we care like family, and we stand with them.”

St. David’s HealthCare will attempt to redeploy staff with reduced hours who work in clinical facilities or support areas in order for them to keep working. If someone can't be redeployed, he or she will receive 70% of base pay for up to seven weeks "until the hospital system better understands the long-term implications of this pandemic on the organization." St. David’s HealthCare said this is to help avoid layoffs and furloughs that other healthcare systems are facing.

As someone who does telemedicine, Van Roekel said many of his patients are afraid to go to the hospital right now because of the coronavirus. He said a free-standing ER offers an alternative for patients.

Van Roekel said his company has forgiven $3.5 million of patient debt over 2018 and 2019 "because we know everyone is hurting."

He said he wants to see the government step in to help the emergency rooms.

"Now with the decreased volume from coronavirus, it really threatens to close over half of [free-standing ERs] or almost all of them if it goes for multiple more months without some help from the government,” he said.

Van Roekel said the stimulus package for small business loans is "a drop in the bucket." He said it will only help keep a free-standing ER open for a couple of weeks.