(In the Beginning recounts the real-life experiences of urgent care operators who have taken the initiative to hang out the proverbial shingle and open a new start-up center. It will be an occasionally recurring feature available exclusively in the digital edition of JUCM.)
Ask Dr. Donna Eget about the greatest benefit to owning an urgent care center and she doesn’t miss a beat; to her, it is time—time with family and time with patients.
The West Nanticoke, PA native worked as an emergency physician for 16 years, though the idea of opening an urgent care center struck her early in her career—“at 5 a.m., on my first night shift!” she recalls with a laugh. Although “it took awhile to put it together,” she reports knowing clearly in that moment that there had to be a “better way” to practice medicine.
Ultimately, however, it was motherhood that provided the strongest impetus to make a significant change.
Twin sons James and Max, now both 6, didn’t quite get it. Coming home late one night after a long night in the ED, Dr. Eget was confronted by James, still sobbing after a bad dream. “How come you have to work?” he demanded to know. Once his mother tried to explain the important role money plays in everyone’s lives, the determined James said that if she would stop working, he would give her his dollar.
He’d struck a chord.
Presumably, James still has his dollar in the Clarks Summit home where he and his family live, nine miles from Medical Express Care (http://www.medicalexpresscare.com/) in Dunmore, PA, a borough of Scranton. Dr. Eget opened her doors last summer.
The center is open seven days a week, 9 a.m. to 7 p.m. and manages 23 patients per day, on average. The visits have grown in spurts, Dr. Eget said, with plateaus in between. She believes they’re on the brink of another spurt now.
Often, it’s Dr. Eget who opens or closes the center even when she’s “off.” Sometimes, she even sees early or late patients on those days to relieve some pressure on the single doctor, PA, and paramedic on staff.
The center has offered x-rays, lab draws, and CLIA-waived tests since opening day, and since then has added diagnostic tools such as Holter monitors and events monitors. Most recently, an onsite prescription dispenser was added as a service for patients.
Dr. Eget points to the ability to interact more closely with patients, and, as a result, “provide them with better care” as a key advantage to practicing urgent care medicine.
She cites an example of seeing a patient early in the day, arranging for needed scans and then referral to a surgeon, after which she is advised of the patient’s condition and can take the time to personally call the patient or attending medical staff and stay in touch during recovery.
Dr. Eget has found that opening her own urgent care center allows for abundant opportunities to influence patient care in a highly personal way. Community response to such interventions has been “tremendous.”
This is not to say that the path is an easy one, of course. At times the start-up process has been “overwhelming,” she says. “Start-up is like being an intern. What you don’t know can kill someone.”
However, for her, the best part is “being home every night and being able to bring the kids to work on snow days if necessary.” The worst? No salary for 10 months (although her reimbursements are being analyzed to correct this situation after resolution of some early billing issues).
Her advice to potential urgent care owners is, “Do your homework. Get help from the experts. Fortify yourself for a long first year; lean times may be ahead. Lean on time, lean on money, lean on recreation, travel, and hobbies. It can be a hard road. You must really want it.”
If you do really “want it,” however, Dr. Eget maintains that taking the leap as a start-up urgent care operator will have growing dividends over time. For her, they include “time with family and patients, not starting your day already five patients behind in an ER, having patients who are happy to see you and who appreciate the access to care you can provide in this setting. There’s rarely any rush.”