First Choice is a gleaming, stand-alone emergency room built like a drive-through dry cleaners, set in an affluent neighborhood to signal convenience to consumers ? and to rake in profits for private investors. But critics say free-standing ERs are creating and distorting demand, not just filling it. "What they're doing is driving up the cost of medical care," said Dr. Vince Markovchick, an emeritus professor of emergency medicine and author of the manual "Emergency Medicine Secrets." Free-standing ERs can charge four or five times what an urgent-care center or clinic charges for common problems such as stitches, abdominal pain or sprains.