Bert,
We were in the same boat with the patients going to ER when the office was open. We were known to scold patients for doing it and misusing the ER but unfortunately the times have changed. We do our best to not send patients to ER but we can't see everybody and that is why urgent care and walk-in clinics exist today.
I understand the not wanting to work with another provider but don't forget you would be the boss and set things up the way you want them done. Having a ARNP would allow you to have a life and not burn out and be able to take time off once in awhile and still have someone in the office to see your patients and know income is still coming in when your not there.
There is no perfect solution for you unfortunately you have to give up some where in order to gain back your sanity for you and your office staff. I hope it all works out in the end.
