A spider bite blew up Stuart Reid's left calf.
In the past, Reid would have headed right to the emergency room. But last month, the part-time Palm Beach resident went to Palm Beach Urgent Care where medical staff assessed it as a bite from the poisonous brown recluse spider.
"It was pretty nasty," said Reid, who also lives in Nantucket, Mass.,
and sells property for a living. "They were efficient and did a great
job. If I was in charge of a hospital, I'd be concerned about these
Urgent care clinics are sprouting up like St. Augustine grass in summer here in South Florida, continuing a trend over the last decade. Hospitals, big-box pharmacies and supermarkets like Walgreens and Wal-Mart are also getting in on the action.
Urgent care is new way of consuming medicine in the age of Obamacare -- estimated to be a $16.2 billion industry in 2015. Worldwide, urgent care clinics are expected to reach revenues of up to $30.5 billion by 2020.
Jim Lobel is the CEO and partner in Palm Beach Urgent Care, with facilities in West Palm Beach and Royal Palm Beach. He also is the CEO and partner in Indian River Walk-in Clinic in Vero Beach. His company serves more than 40,000 patients a year among the three clinics.
"It's anecdotal, but I believe Obamacare has played a huge part of
it," Lobel said. "We are seeing more insured patients as a result of
Dr. Franz Ritucci, president of the American Academy of Urgent Care Medicine, based in Orlando, agreed: " More people are getting their insurance and they are saying, 'You know what? I can go see the doctor now.
'"It's estimated by market analysts that there are more than 9,400 walk-in urgent care clinics in the United States with between 50 and 100 coming on-line each year.
The patient who needs immediate relief for a variety of ailments can
come to the clinic and may eventually be referred back to the family
"Although some providers believe urgent care centers
disrupt coordination and continuity of care, others believe these
concerns may be overstated, given urgent care's focus on episodic and
simple conditions rather than chronic and complex cases," according to a
2013 brief by the nonpartisan Center for Studying Health System Change in Washington.
Lobel said most patients choose their urgent care clinic because of
location or word-of-mouth. He warned though not all clinics are equal,
noting more than 50 percent of clinic owners have only one facility.
from patients usually are about wait times, followed by misdiagnoses.
For clinics to survive, quality of care is paramount to sustaining this
new paradigm in providing medical care.
"The question we ask our
patients in our surveys isn't 'Would you come back?' It's 'Would you
recommend us to somebody else?'" Lobel said.
Dr. Peter Lamelas, founder of West Palm Beach-based
MD Now, says a lot of these single-facility clinics are not true urgent
care centers and that the growing regulatory burden eventually will
force these mom-and-pop providers to make some crucial business
"I think the market will shake itself out," Lamelas said. "The little
locations will have difficulty. They will get bought up or they will
One repeat customer without complaints is Wall Street.
MD Now received an infusion of money from investors in March 2012 and has expanded the business from six clinics to 21 with plans to grow more."I
wanted to create the anti-emergency room," Lamelas said.
"I wanted to
fill the void between the family practice doctor and emergency room. The
gap in care I knew was missing."
Hospitals indeed have taken notice. JFK Medical Center in Atlantis and West Boca Medical Center have spun off whole ER operations, setting up satellite operations in suburban locations. JFK has stand-alone ERs in Boynton Beach and Palm Beach Gardens, and West Boca Medical is opening one in Coconut Creek in early May.
Mitch Feldman, the CEO of West Boca Medical Center, said the hospital's new free-standing ER about to open down U.S. 441
doesn't look to compete with urgent care centers. It is in position,
however, to care for patients from direct competitors, from North Broward hospitals.
idea is these patients will come for a sprain and then choose West Boca
when they need a more involved procedure. "We will be able to retain
them completely in our health system for all of their care," Feldman
said. "We would have more complete service care."
As the hospitals
duke it out, the urgent care centers are reaping the rewards on the
non-emergency care side, redefining the doctor's office for the 21st
Urgent care clinics are staffed by doctors and health practitioners,
but they are not emergency rooms. Walk in with a symptoms of a heart
attack and the receptionist will call an ambulance. But for a cut, a
sports injury or a urine test, urgent care clinics fit the bill. They
are open on weekends and at night -- unlike the office of many family
People are seeing the benefits of coming to us
rather than going to ER," Lobel said. "There is a social conscience
point of view, as well. Why would we want the ER being cluttered up by
patients who don't need that service? The ER's don't want them and the
general public doesn't want to be there."
Ritucci said the urgent care business model brings the fast-food approach to medicine.
"I term it the McDonald's society. We want what we want when we want
it," Ritucci said. "It is care convenience. When you look at urgent care
centers they are open between 12 and 16 hours. They are open every day.
You can go before work, you can go on your lunch hour, you can go after
Unlike a doctor's office where one assistant might
multi-task, urgent care centers have people designated to take vital
signs, to stitch up lacerations, draw blood, perform X-rays, lab
samples, etc. "The design of the centers is so they are able to see
higher volumes of patients in the efficient manner," Ritucci said.
Dr. Alan B. Pillersdorf, president of Florida Medical Association,
said he thinks urgent care will raise the bar for hospitals. "I welcome
the competition of the urgent care clinics because then local hospitals
will have to be nicer and have to earn the customers' respect again,"
nd urgent care centers are hitting the mark with patients who need
flexibility. When Palm Beach Urgent Care extended the hours of its
clinic on Okeechobee Boulevard, it found a number of people with worker's compensation claims coming through the doors.
Lobel, who describes himself as a serial entrepreneur, spent hours in a California clinic once just monitoring patient traffic. After that, he extended the hours at his West Palm Beach location until midnight on weekdays.
"Opening an extra four or five hours at night isn't cheap," he said. "But people hurt themselves all hours of the day."
And employers like it because the urgent care clinics can do it so cheaper than emergency rooms. A New York Times story in 2014 found that treating bronchitis was nearly $700 cheaper at an urgent care facility.
with urgent care clinics proliferating like ducklings, could there be a
saturation of the market? There are only so many patients to go around.
Lobel doesn't think so.
get into a bubble, and then you have a consolidation," he said. "They
do seem to be everywhere, but I got to tell you our business just on the
urgent care side has grown by more than 30 percent in the last year.
The patient load from my perspective keeps on increasing. I don't see
how we've reached the saturation point."
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