Freestanding emergency rooms may be a trend to watch in the coming years.  

So far, most states have not yet approved the creation of such facilities. The emerging industry is largely based in Texas, which became the first state to allow them in 2010.  

The decision to authorize them in Texas appeared to be aimed at a dearth of ERs in the state. Given an "F" in a national report by the American Academy of Emergency Physicians, there are many Texans without access to a nearby ER.  

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