When Doctors Care opened its first office in Columbia in 1981, it was decades ahead of its time. The company likes to say it was “disruptive” of the long-standing medical delivery model.
In the past decade, and especially in the past three years, what was once out-of-the-ordinary has become a major category referred to as “retail medicine.” Just look around the Midlands for evidence.
In Richland and Lexington counties, there are 11 Doctors Care offices, eight CVS MinuteClinics and three MEDcare Urgent Care offices. The hospitals jumped on the bandwagon several years ago, realizing their emergency rooms were overwhelmed with people who needed timely, but not necessarily true emergency, care. Lexington Medical Center has six urgent care facilities, and Palmetto Health has two.
And many in the industry expect the demand for no-appointment, extended-hours care to explode with millions of people getting health insurance under the Affordable Care Act.
“We’ve been ready for (the ACA) for months,” said David Boucher, CEO of Doctors Care. “We think that there’s pent-up demand, and we think that it’s significant.”
Doctors Care actually slowed its expansion rate in the past year, focusing instead on improving existing facilities and solidifying staff at its 52 offices – all but one in South Carolina. The effort included installing electronic health records systems to help handle the oncoming wave.
Others in the varied retail medicine niche have been growing at amazing rates in recent years. The Urgent Care Association of America says there are more than 9,000 centers in the U.S. now. Merchant Medicine, which advises those in the business, breaks down the numbers differently, counting 4,024 urgent care facilities (78 in South Carolina) and 1,456 retail clinics (30 in South Carolina).
It’s still a niche, but a growing one. Six years ago, 1 in 10 people in the U.S. had visited a retail medicine facility. By 2012, it was 1 in 5, according to health care market research publisher Kalorama Information.
Deloitte Center for Health Solutions expects the number of clinics in retail stores such as CVS, Walgreens, Target and Wal-Mart to double in the next two years. Walgreens, Target and Wal-Mart all have facilities in either Georgia or North Carolina, so they’re knocking on the door of South Carolina.
MEDcare is a relatively new player in the field, though its founders were physicians with years of experience in emergency rooms before opening a first facility in Charleston in 2006. The three Columbia facilities have opened within the past two years, positioning the company to handle newly insured patients in 2014.
“As cost and condition barriers decrease, more lives will be covered, and that means more opportunity for us to extend our brand of health care,” said MEDcare CEO Dr. Radwan Hallaba.
MEDcare’s facilities are set up to handle more urgent cases, with full lab and X-ray capabilities. Doctors Care has urgent care capabilities, too, but focuses as much on helping patients for a variety of standard needs such as flu symptoms or a quick sports physical. CVS MinuteClinic is a convenient place to take kids with sniffles or to get a flu shot.
MEDcare pledges to have a doctor on site at its facilities. Doctors Care tries to have physicians at each facility at all times, but it also uses physicians assistants and nurse practitioners. MinuteClinic relies heavily on nurse practitioners.
“We don’t do sutures,” said Dr. Andy Sussman, president and chief operating officer of MinuteClinic. “We don’t do abdominal pain. (The urgent care facilities) are pretty complementary with what we do.”
They all refer true emergency patients to hospital emergency rooms, and they recommend their patients with chronic illnesses find a primary care physician at a standard practice.
“We believe in a physician-led patient-centered medical homes, but we believe a lot of people are medically homeless,” Sussman said. “Frankly there’s a lot of needs. We think our model can help in what is going to be a shortage of providers.”