According to Maryland's association of physicians and doctors, the state is facing a shortage of emergency room doctors. They place the blame on low reimbursement rates from insurance companies:

"'Because emergency services physicians are in short supply, they are demanding high salaries,' [Dr. Louis] Pimentel said. 'The reimbursement rates are not keeping up with what they can get in Virginia, where the reimbursement is much better.''

As the article goes on to point out: "According to the physicians association — the Maryland State Medical Society, or MedChi — about 85 percent of insurance coverage in Maryland is controlled by two companies, CareFirst BlueCross BlueShield of Maryland and Mid Atlantic Medical Services LLC, a subsidiary of UnitedHealth Group Inc."

Maryland has made it very difficult for insurance companies to operate in the state. Its level of mandates is among the highest in the nation and the Maryland Health Care Commission places such stringent regulations on insurance companies that it is little wonder that two companies dominate the market. It is difficult for others to gain a foothold, or they simply do not want to do business within the state's borders. Unfortunately, the likely result of this doctor shortage will be that the state will start regulating the reimbursement rates for ER doctors.