Published: November 28, 2009 04:49 am      

Urgent care clinics have identified growing need

Relieve crowding at doctor’s offices, emergency rooms

SOUTH CHARLESTON — On a typical day in South Charleston, Dr. Gregory Burnette treats a few babies with fevers, a few sprained ankles and sinus infections and, these days, plenty of flu sufferers.

Burnette does not work at a hospital, though, and isn’t treating patients in his own primary care office. He’s a physician at MedExpress, part of a growing number of urgent care clinics around the country that are well placed, advocates say, to fill gaps in the overtaxed health care system.

Urgent care clinics are for people with relatively minor ailments who can’t get timely appointments to see their primary care doctor, if they have one. In theory, the clinics relieve crowding in doctors’ offices and at emergency rooms, which too often have become default care centers for people with complaints better treated elsewhere.

Burnette saw the problem first hand working as an emergency room doctor for 25 years before joining MedExpress.

“I was getting tired of seeing people who waited four, five, six hours for treatment in the emergency room,” he said.

And while privately owned urgent care clinics may seem intended for people with private health insurance, they’re becoming flexible in how they bill for services.

MedExpress, for example, accepts most types of Medicaid in West Virginia, where at any given time more than 300,000 people are insured through the government plan. The company’s clinics also treat people without insurance, although they must pay $115 up front.

South Charleston is the newest clinic opened by Morgantown-based MedExpress, which has expanded since its 2001 founding to include 40 clinics in Pennsylvania, Florida, Colorado and West Virginia, which has eight.

The company says it’s had about 200,000 patient visits in West Virginia so far in 2009. All told, there are about 20 urgent care clinics in the state.

Co-founder Dr. Frank Alderman was, like Burnette, an emergency room physician who saw flaws in situations that packed stroke victims alongside people with sore throats.

“It was a common situation to find that seven or eight of the first 10 charts I’d pick up would not be true emergencies,” Alderman said. “But it’s an access problem. Where else are these people going to go?”

Patients who use emergency rooms for non-emergency ailments are a problem for hospitals. In 2006, there were more than 119 million emergency room visits, according to a survey by the federal Centers for Disease Control and Prevention. Just 13 percent of those were serious enough to require hospitalization, and the median time spent in the emergency room was over two and a half hours.

On the other side of the urgent care picture, access to primary care providers is still a challenge for many Americans, especially in rural states like West Virginia.

The West Virginia Primary Care Association is currently assessing the state’s medical provider needs, in terms of the size, health and geographic distribution of its population.

The study isn’t finished yet, but CEO Louise Reese said they’ve already noticed some larger patterns.

“What we have found in some cases, in some regions, there’s not necessarily a shortage of providers, but there’s a maldistribution,” she said. “They tend to gather in more urban areas, and we’ve found it’s sometimes difficult to get providers who are willing to live in the most rural communities.”

Other health care providers in West Virginia say there’s a place for the urgent care clinic, although they caution it has limits.

“Urgent care facilities are complimentary in the sense that a priority for hospitals is to avoid over-utilization and unnecessary use of its ER,” said Tony Gregory, the West Virginia Hospital Association’s vice president for legislative affairs.

But the range of treatment available at urgent care clinics is limited compared to hospitals, Gregory said, and people with real emergencies — heart attacks, stroke, serious injuries and the like — should not make the mistake of stopping at an urgent care clinic first.

Gregory said patients also shouldn’t forsake building a medical history with a primary care doctor simply for the sake of convenience.

“The concerns from a standard of care perspective are really about the patient substituting urgent care for an ongoing relationship with a primary care physician,” he said.