The findings of the 2014 Emergency Care Report Card found at; , indicate that, as a whole, the emergency care environment in the United States has worsened and patients continue to face significant challenges in accessing life-saving care. Overall, the national grade has declined to a D+, reflecting subpar grades in three of the five categories measured. The nation continues to perform worst in Access to Emergency Care, for which it earns a D-.  The painful reality is that over the years, emergency room waiting times across the nation continue to increase as the population increases while the number of actively practicing private physicians decrease.  This is very much the case in Arizona.

The patients in the Center for Executive Medicine avoid unnecessary waiting in emergency rooms as well as trips to the doctor for routine conditions that can be treated with a simple phone call to Dr. Mariano.  Because CEM’s patients enjoy an ongoing relationship with Dr. Mariano, patients are able to contact Dr. Mariano for medical questions or concerns. CEM patients typically undergo an annual exam of over an hour meeting with Dr. Mariano.  Because patients feel free to email or call Dr. Mariano anytime, an ongoing relationship with Dr. Mariano is maintained.

When patients develop a recurrent condition such as bladder infection, seasonal allergies, respiratory infection, or back pain, CEM patients contact Dr. Mariano by phone or email.  Knowledgeable of the patient’s past history, Dr. Mariano is then able to order necessary testing or prescribe appropriate medications for the patient.  Dr. Mariano follows up with her patients after the initial call and if the patient’s condition does not improve, Dr. Mariano sees the patient for follow up. As a result of this access to a physician, a visit to an urgent care center or emergency room is averted, saving the patient time and money.

The Center for Executive Medicine has a proven track record of providing same or next day appointments in nearly all cases and, when it is not possible, to provide an appointment that fits the patient’s busy schedule.  CEM patients also get a doctor who has spent enough time with them to recognize when her patient has that “not-feeling-so-great” voice” or appearance which allows her to quickly assess the situation and provide accurate medical intervention.

If a patient’s medical condition warrants emergency room evaluation, Dr. Mariano is able to facilitate the patient’s care by calling the emergency department directly while the patient is enroute.  Dr. Mariano contacts the emergency room physician to discuss the patient’s condition and follow up care after discharge from the emergency room.  If the patient is admitted to the hospital, Dr. Mariano visits the patient in the hospital and is in contact with the hospital team to facilitate a smooth hospital course and discharge to home and follow up care with Dr. Mariano.