walk inn clinics

It's not hard to see the allure of emergency care clinics - they're open at night and on weekends, you can walk in without an appointment, and in some areas of New York City they're becoming almost too ubiquitous than Starbucks. While critics say emergency care patients don't enjoy the quality of care that comes with a long-term doctor-patient relationship, these walk-in centers have set a new precedent of convenience and service for clients. Such as the city's public health system and other service providers. Try to fight back.

Atlanta-based emergency care chain has 23 emergency care centers in New York City and plans to nearly double its presence by the end of the year. But it's not trying to compete with primary care physicians, said Todd Latz, the company's chief executive.

"We have referred more people to primary care than we have eliminated," Latz said, during a panel discussion on urgent care at the Crain "Doctor's Office Outage" health care summit on Monday. He added that GoHealth's relationship with Long Island-based Northwell Health healthcare system allows it to refer patients to specialists or other types of providers when needed.

GoHealth office workers always ask patients if they have primary care doctors and those who don't want them if they want one, Latz said. Some people are taking up GoHealth's offer to help them find a primary care doctor they can see for more ongoing care, but he said millennials are generally not interested.

“They generally view health care as episodic in nature,” he said.

Urgent care resonates with people accustomed to nature at the request of other industries, said Dr. Michael Goldstein, Manhattan ophthalmologist and president of the New York County Medical Society. “The same person who decides to order shoes online at noon goes to the emergency care center,” he said.

But there are downsides to episodic care that many patients aren't aware of, Goldstein argued. Emergency care clinics, which often have medical assistants or other mid-level professionals rather than doctors, won't necessarily be able to spot serious medical problems. They may also be more prone to misdiagnosis and are less equipped to help patients manage chronic conditions like diabetes, Goldstein said.

NYC Health + Hospitals, the city's public hospital system, strives to take advantage of the ease of access and customer service that emergency care provides at its outpatient clinics, said Steven Bussey, head of ambulatory care from H + H. This means extending hours and quickly adding new locations.

But Bussey stressed that the primary goal of the healthcare system is to improve the long-term health of the patient, a goal that is also financially motivated. Medicaid and other insurers are increasingly designing payment models that reimburse providers based on improvements in the health of their patients.

"If you don't get results, you won't get paid," Bussey said. He said the key was coordinating patient care and educating them about their medical needs.

Dr. Richard Park, general manager of the CityMD emergency care chain, which has more than 50 locations in the metropolitan area, insisted that his channel also aims to get patients to change their behavior for the better. The way to do that is to build a high level of trust, he said.

"I'm not talking about any level of confidence," Park said. "You have to create a trust similar to Oprah's."

When asked whether involving private investors in emergency care could present a conflict of interest, Latz and Park said they only need to make sure they choose partners whose missions align with theirs.

"If you can't provide the right level of care, interact with patients and create an environment that they want to return to, no matter what your initial financial investment thesis is, you will not be successful," Latz said.

Working with private investors is not out of the question for the city's public hospital system, Bussey said. He noted that the state has been studying the role of private investors in healthcare for many years.

"It's a tough conversation to have," Bussey said. "It depends on the circumstances and how you make it profitable for partners on both sides."

"Do emergency care centers have your best interests in mind?" originally appeared on Crain's New York Business.