Urgent Care Excellence in Downtown St. Louis

On a recent weekend, as with many weekends, I found myself in a different city with my son's soccer team. The team was playing a tough game, and Jack (not his real name) was flying down the far sideline and went up for a head ball. A player from the other team did the same thing and their heads made an attempt to violate the law of physics that two objects can not occupy the same space at the same time. Both young men crumpled to the ground in pain. Jack was moving but when the coach got to the far sideline, he immediately waved for me to come across the field. When I got there there was blood streaming from a laceration in his eyebrow. We wrapped his head with a tightly-tied tee shirt and held pressure to the wound.

The fields were at the Washington University Academy in downtown St, Louis. Two years ago, we would have had no choice but to go to an urgent care in the suburbs or to a downtown hospital emergency department.

But I was well aware that my friend Sonny Saggar, MD had opened a new urgent care in downtown St. Louis.  Prior to opening, Sonny had shared his vision of a downtown urgent care center for the people of St. Louis.  As with many startup urgent care centers, Sonny faced some significant hurdles:

• Inept Consultants: He tried one of the Practice Velocity^® startup imitators--that offer all-in-one startup help--that is "just as good as" Practice Velocity.  What he found out, however, was that the consultant had minimal experience in opening a single (and somewhat unsuccessful) urgent care center in a far-away state.  
• Inexperienced Billers: The all-in-one startup company vaunted it's urgent care focus, but the head of the company had been a hospital executive and had no significant urgent care experience.  The billers he had hired had no urgent care experience.  
• Wrong EMR: The  all-in-one startup company advertised its one-of-a-kind, "first true urgent care EMR" software.  Yes, the software was one-of-a-kind, but Dr. Saggar discovered that it was cumbersome and impossible to use efficiently in real-life urgent care situations.  NOTE: Although other companies might advertise that they offer an "urgent care EMR," the Practice Velocity VelociDoc^® EMR is the only EMR made in urgent care centers by urgent care professionals from the beginning.  In fact, VelociDoc is so specific for urgent care and occupational medicine that we do not even recommend it for any other type of practice.
• Tough Demographics:  Prior to his opening, we discussed the difficulties of urgent care centers located in downtown in major cities, especially cities such as St. Louis that have modest populations, living in the downtown area.  I told him that it would be tough, and I would recommend that he try a different location for his first center. Sonny loves a challenge, and he has a passionate commitment to the city. He later shared with me that my words of caution made him even more determined to succeed.  An succeed he did.  Upon our visit, we find that he has even expanded his services to include the only primary care practice in downtown St. Louis.

Now, back to the soccer injury.... We jumped into our cars, I Google-mapped "downtown urgent care st louis" on my Palm Pre, and ten minutes later Jack was receiving care from the excellent staff at Downtown Urgent Care.  Check out the cool graphics in his logo.  As you can see, they are located right on the street a lighted sign right over the window.  The waiting room is ample, but feels even larger because of the high ceilings.

An hour later, Jack was eating lunch in the car on the five-hour drive back to our homes in Chicagoland.

Thanks Sonny, for your persistence in making sure that the people of downtown St. Louis (and the visitors to the city) have access to quality urgent care service.  Jack's stitches are out, he is fully recovered, he scored a goal yesterday, and his parents are very thankful to Sonny and his excellent staff at Downtown Urgent Care in St. Louis.

Sisters of Mercy Urgent Care: Check Out This Beautiful Clinic

Asheville, NC, nestled in the Blue Ridge Mountains, is known for being the boyhood home of novelist Thomas Wolfe and the site of America's largest home George Vanderbilt’s 250-room Biltmore House. It may not be well known, but Asheville is, also, home to one of the most stately urgent care centers in the USA--Sisters of Mercy Urgent Care West.

I had the pleasure of meeting with their dedicated staff last week, as they worked with me to implement Practice Velocity solutions to systematize the charting and coding for their urgent care centers. Upstairs, the urgent care center has a beautiful conference room, administrative offices, and a view across the valley. Downstairs the center has a spacious and tastefully decorated waiting room, a door to the clinical area that requires manual electronic access by the receptionist, ample exam rooms, and a semi-private charting area for providers. There is ample parking in the back and a covered driveway to allow for protection from the elements when dropping off a sick patient.

The center has a large, lighted sign on the street. Still, one other aspect of the center ties in with a previous post. When you drive up the road to the center, you will see it framed with the large billboard, telling the community, "We're here for you." Practice Velocity congratulates the staff of Sisters of Mercy Urgent Care Centers for being there for the urgent care needs of the people of Asheville.

Listing Wait Times Online: Is it a good idea?

We frequently are told that a startup urgent care center has a great idea, they are going to post their wait times right online. It sounds like a great idea, with a direct view toward good customer service. People have the information and can decide whether to come in now or later. This afternoon we sampled the websites for two urgent care centers that post wait times. Snippets from their websites are attached. This afternoon's research seemed to indicate that both clinics were quite backed up. Does anyone seriously believe that very many website visitors actually visited the clinic today? On the other hand, if your goal is to attenuate visit volumes on busy days, could you come with a better way to discourage clinic visits?


It's not a new idea, and we have generally discouraged placing wait times online for several reasons:

• Wait times may be high now. But you may be caught up in 30 minutes, which may be the time that it would take a visitor to your website to drive to your center. Patients are interested in the wait time for when they arrive at the clinic, and that has little to do with the current wait time in the clinic.
• Staff will likely exaggerate wait times. It is human nature for staff to want to reduce their workload.
• The term "wait time" is ambiguous. What is a "wait time?" Time that you will wait to see the doctor? That's probably what most patients think. Or is it the throughput time for patients? That's what many centers mean, but this time is often over 60 minutes, even when time to see the doctor is really under 30 minutes
• Patients won't necessarily come in later. They may choose to go to another center. Is that what you want?

Patients aren't so much worried about the wait times for everyone else in a clinic, they are really concerned about what their own wait time will be. Is there a way to control that? Yes. Practice Velocity's client clinics use our ZipPass^® product for FREE. With the click of a mouse, visitors to the urgent care website (and visitors to the center's GoUrgentCare.com directory page) can "get in line, online." The software automatically uses the algorithm selected by the center to determine the next available appointment. This accomplishes three important goals for the urgent care center:

• Operations Efficiency: ZipPass smooths out patient flow, by pushing appointments out when the clinic already has many patients in the clinic.
• Patient Convenience: Barring an emergency patient visit, ZipPass holders are first in line when they get to the clinic. What a great deal! Who cares how long the line is; they are first in line. If any other patients seem unhappy with the ZipPass patient "cutting in line," your staff can simply offer them a brochure about the ZipPass service, "So next time, you can be first in line too."
• Marketing Effectiveness: ZipPass converts website visitors into clinic visitors. If you doubt whether this will work, consider this fact: 85% of people who fill out a ZipPass^® show up for their appointment.

If the idea of appointments (even same-day appointments) is foreign to your conception of an urgent care, maybe you can look at it this way. Patients are not really making "appointments," they are simply getting in line from their home or office. Rather than wait in your waiting room, they can wait in the comfort of their home or office. You see more patients. You see them more efficiently. They get the convenience of shorter waits. It seems like a win for everyone involved.