Northwest Texas Healthcare System (NWTHS) has temporarily shuttered its freestanding emergency departments (FEDs) on Hillside and Georgia due to an ongoing pay dispute involving emergency care providers. The closures, now in their sixth day, stem from emergency doctors, nurse practitioners, and physician assistants halting work over unpaid wages from their employer, NES Health.
The Root of the Crisis
NES Health, the third-party contractor responsible for staffing the FEDs, failed to pay providers for work performed in October and November. NWTHS CEO Jason Barrett issued a memo on Saturday addressing the situation, emphasizing that the healthcare system fulfilled its financial obligations to NES under their contract.
“As employer of the physicians and allied healthcare professionals that staff our EDs, NES is responsible for paying those professionals – NOT NWTHS,” Barrett wrote, adding that the hospital had advanced funds to NES earlier in the month to assist in resolving the issue.
Despite this advance, NES informed NWTHS that it would not be able to meet payroll obligations, prompting NWTHS to declare NES in breach of contract. Efforts are now underway to transition to a new contractor to manage emergency services, Barrett confirmed.
Impacts on the Community and Providers
The closures have disrupted access to emergency care, with patients who would have visited the FEDs now overwhelming NWTHS's main emergency department and other area facilities. The FEDs previously treated 150-180 patients daily, creating a significant strain on an already overstretched system.
“We don’t have enough primary care providers,” said Dr. David Pearson, an emergency physician, highlighting the ripple effects of the closures on the community. “This inaction has the potential of driving even more physicians away… adding strain to a strained system.”
Emergency physicians expressed frustration over unequal pay resolutions. While providers at NWTHS’s main emergency department were reportedly offered full compensation for the missed October and November paychecks, FED physicians were initially offered 48%, later increased to 57%.
“This is inequitable,” said Dr. Frederick Poage. “We’re all under the same group. Why are we treated differently?”
Dr. Jacob Zeiler echoed the sentiment, emphasizing his willingness to return only under fair contract terms. “I’m not willing to come back unless we’re treated fairly. It’s just that simple.”
Concerns Over Leadership and Future Stability
Physicians also voiced skepticism about NWTHS leadership's ability to ensure stability with future contract providers. One doctor criticized the executive team, saying, “I doubt the competency of this leadership at Northwest.”
Poage noted that this would mark the fourth contractor change for FED staffing in eight years, underscoring a pattern of instability.
Further compounding the issue, physicians working at the main NWTHS emergency department are reportedly operating without signed contracts or malpractice insurance, relying solely on verbal assurances. “That’s a scary situation,” said Poage. “I will never do that.”
Next Steps and Community Outlook
NWTHS is finalizing a transition to a new contractor and is working to recruit existing providers to ensure continuity of care. Barrett assured staff that the FEDs will reopen “in the coming days” once new agreements are in place.
However, the delay has already caused significant disruptions. With the holiday season approaching, patient volumes are expected to rise, intensifying pressure on emergency services.
“We want to be there for our community,” said Pearson. “But decisions are being made by people who don’t live here, and it’s hurting us all.”
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