Are Urgent Care Clinics the New Hospitals? Increase of clinics a direct response to uncertainty in healthcare

As the owner of Bayside Docs Urgent Care in Traverse City, Dr. Michael Parker is at the center of one of the hottest trends in medicine: urgent care.

Urgent care clinics are growing rapidly as patients seek to avoid long waits and higher costs at busy hospital emergency rooms and physician offices.

The number of urgent care clinics in the United States has grown 25 percent since 2008, from 8,000 clinics to an estimated 10,000 today, according to the American Academy of Urgent Care Medicine.

“Urgent care clinics represent an innovation in the U.S. health care market that evolved directly from the health care system’s shortcomings,” said Bruce Carlson, publisher of Kalorama Information, a Rockville, Md.-based health care research publisher.

Total revenue at these clinics has jumped 27 percent from $11.8 billion in 2011 to a projected $15 billion this year, a result of rising patient volumes and expanded services, Kalorama said.

“We take care of anyone who walks through the door,” said Parker, who opened his Munson Avenue clinic in 2001. “Our focus is on patient care and patient satisfaction.”

Bayside Docs, with a staff of about 20 full- and part-time employees, treats minor issues such as sinus infections and sprained ankles. The clinic also offers school sports physicals. Patients with more serious problems are referred to an emergency room.

Parker said Bayside Docs’ patient volume has been steady at roughly 10,000 visits a year for the past several years. Two other urgent care facilities serve patients in the Grand Traverse region: The Walk-in Clinic on U.S. 31 South and Munson Urgent Care across from Bayside Docs.

Parker said the urgent care market may be saturated, since primary care physician offices are expanding their hours and are keeping open some same-day appointments under pressure from Medicare.

“We’re pretty much maxed out,” he said.

Parker, 63, founded Bayside Docs after moving here with his family from Chicago, where he worked for 20 years as an emergency room physician. He said he became enamored with Traverse City while playing in rugby tournaments here during his years of medical training in Grand Rapids.

“It was like I had died and gone to heaven,” he said about seeing the area for the first time.

But his view of the health care industry isn’t so lofty: Prescription drug prices are out of control and health insurance is rapidly becoming unaffordable for many Americans.

“My perspective is that things have deteriorated a lot,” Parker said.

The EpiPen, used to treat allergic reactions, drew Congressional scrutiny earlier this year after its price jumped 500 percent between 2009 and 2016. But Parker said the EpiPen episode is “just the tip of the iceberg.”

He said he recently wrote a prescription for doxycycline, an antibiotic that he says “Meijer used to practically give away.” He later got a call from the patient saying he couldn’t afford the $130 cost of the drug.

Tetanus shots used to cost Parker $2 a shot, but have recently jumped to $23 a shot.

“They’re charging outrageous prices for everything,” he said.

And Parker predicted that the Affordable Care Act, known as Obamacare, will collapse within a year or two because of increasingly unaffordable coverage mandates and rising premiums in the exchanges where individuals can buy health insurance.

Critics claim the Trump administration is undermining Obamacare after Congress failed in multiple attempts to repeal and replace the sweeping health care act.

Among other things, the administration has cut funds advertising this year’s open enrollment period and trimmed financial assistance to states that enroll residents.

On Oct. 12, President Donald Trump signed an executive order directing three cabinet agencies to develop rules that would allow some trade associations to offer cheaper health insurance policies to their members. These policies would be exempt from various Obamacare coverage requirements, such as maternity care.

The next day, Trump scrapped subsidies to insurance companies that help low-income people pay out-of-pocket health care costs.

Parker said he thinks the answer to the health care crisis is to extend Medicare, now available to those 65 years and older, to everyone who wants it. The cost of deductibles and copays would be based on income.

“There must be access to health care for everyone,” he said. “And everybody has to pay something.”
The current system rewards those covered by insurance and punishes those without insurance or high deductible policies.

“Who can afford $5,000 [for a deductible or procedure not covered by insurance]?” he said. “It can lead to bankruptcy.”

Under Obamacare, those who can afford health insurance but don’t buy it are subject to a fine.

But Parker said he’s pessimistic about the prospects of Congress and the Trump administration reforming health care financing, because powerful lobbying by pharmaceutical firms and others profiting now don’t want major changes.

“There’s a simple solution: Medicare for all,” he said. “But the politicians won’t go for it. They don’t ask the patients, physicians or nurses how to fix it. They listen to the big spenders, not the little guys.”

Parker does see big changes occurring in the urgent care business. Hospitals are expanding their urgent care clinics and big pharmacies, including CVS with its CVS Minute Clinics, are entering the arena.

“The big guys are buying everybody up, and patients want urgent care clinics that are linked to a huge health care system,” Parker said. “That’s the future.”

Parker doesn’t rule out someday being acquired by an outside health care system wanting to enter the Traverse City market, but he plans to run his clinic independently for as long as possible.

“This is my retirement,” he said. “This is what I want do for as long as I am able. I love seeing patients.”