News & Press: Urgent Care News

Urgent Care Business Booming Across St. Louis Area

Monday, September 25, 2017   (0 Comments)
Posted by: Kish Pisani
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When neighbors learned that a 97-year-old building in Richmond Heights was being torn down to make way for a new urgent care, social media erupted.

Why, area residents wanted to know, was another urgent care needed in a neighborhood that already had eight similar clinics in a 2.5-mile radius?

Dr. Matt Bruckel plans to put his 15th Total Access Urgent Care facility at Clayton Road and Big Bend Boulevard, dislodging a longtime floral shop and the old building.

Urgent care clinics “just seem to be everywhere now,” said Ann Walsh, of Dogtown, who drives by the corner every day. “I think they are flooding our area.”

Urgent care clinics “just seem to be everywhere now,” said Ann Walsh, of Dogtown, who drives by the corner every day. “I think they are flooding our area.”

The urgent care business in the St. Louis region is booming. The clinics are popular among patients who need medical attention quickly but want to avoid the expense and time involved in an emergency room visit, previously the only way to immediately treat ailments without waiting weeks to see a primary care doctor.

Locally, emergency room doctors have gone into the urgent care business for themselves. And hospital systems — including Mercy and SSM Health — have opened their own clinics, in part to keep nonemergency cases out of their hospitals.

Urgent care clinics can mend broken bones, stitch up open wounds and even dispense medicine. Most are for-profit and take private insurance. Many take Medicaid, the government-run health insurance for the poor.

The clinics first appeared in the 1980s and took hold over the next decade. By 2013, urgent cares were a $5 billion industry, according to a medical journal article by Dr. Ateev Mehrotra, a Harvard professor who studies new delivery models like retail clinics and their effects.

“The popularity of these new options indicates that they fill an unmet need,” Mehrotra wrote.

Mehrotra said the urgent care models challenge the industry’s status quo. Primary care physicians usually don’t see patients on evenings or weekends, and it can take weeks to get an appointment. On the other hand, hospital emergency rooms aren’t efficient for treating minor illnesses or wounds. And insurers are balking at paying the costs when they determine the visit wasn’t an emergency.

With a high volume of patients, the clinics have a high potential for profits. Bruckel said his Total Access Urgent Care facilities, not all of which are profitable, treat 250,000 patients annually, or about 600 to 700 patients a day.

Total Access has opened 14 facilities since 2008, and has nine more under development for a total of 23 sites.

“Patients want to grocery shop in their neighborhood, and they want to go to the bank in their neighborhood, and they want to go to the doctor in the neighborhood,” Bruckel told the Post-Dispatch. “In addition, they want it easy and fast and at their convenience, and they don’t want to wait two to three weeks with their primary care doctor.”

One of Bruckel’s competitors questioned the need for multiple sites in a small geographic area.

“The situation we have in Richmond Heights doesn’t need to happen,” said Joseph Seibel, CFO and director of operations at Our Urgent Care, which opened at 1201 South Big Bend Boulevard last year, just three blocks from the planned Total Access clinic. “Them opening that location so close doesn’t make me pleased.”

Our Urgent Care, started in 2006 by a group of five emergency room doctors from Christian Hospital in north St. Louis County, has six locations and plans for two or three more in the next year, Seibel said. The St. Louis market overall is not oversaturated, he said.

Emergency room physicians say they move to urgent cares for more regular schedules with lower stress. Running an urgent care usually means better hours, less complicated cases and patients who have insurance.

Urgent care clinics can fill a gap in rural areas and inner cities that have a shortage of health care options. There are at least two urgent cares in north St. Louis, which has no hospital.

Since urgent care clinics are unregulated in the state of Missouri, their exact rate of growth is unclear. Unlike hospitals, urgent care centers do not have to earn approval from state health regulators for new construction. Also, unlike hospitals, they’re not legally required to treat anyone who shows up regardless of their ability to pay.

Anna Schmidt, of St. Louis, said she appreciates urgent cares as a patient, for getting seen quickly, and as a registered nurse, for keeping people out of the emergency room.

“I don’t have a primary care physician,” said Schmidt, 29. “If you have the sniffles or an ear infection, you don’t want to sit in the waiting room at Barnes.”

This article was updated to reflect that many urgent care centers take Medicaid.


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