Building the Bridge in Medical Care

I was on a good run in the kitchen. After all these years, I had never injured myself so bad that it required stitches. The odds that nothing was ever going to happen was too good to be true. I sliced open my finger on a recently sharpened knife while cutting an onion. It was a nice slit and the bleeding did not cease so I finally made my way over to the Insta-Care Facility in Park City.

I am a huge fan of these businesses. They are a bridge between your regular doctor and the emergency room. I have found them to be efficient (been to others for different reasons) and in general they work. I was in an out of this one in less than an hour with four stitches in my finger.

The most interesting part of the visit was my conversation with the doctor. He was from the Newport News area of Virginia. 26 years ago, with two other emergency room doctors he had worked with, they started an Insta-Care type storefront. Their thesis was to treat emergency room patients. They had prices for each procedure, it was a for-profit business, they charged everyone the same amount regardless of insurance or not (that is an entirely different conversation). Everyone in the medical community told them that the thesis wouldn’t work that they would have to provide annual patient care. They shrugged their shoulders and buil the business.

Fast forward they had six of these facilities, had been in the business for 18 years and was doing quite well. A bill is passed in Virginia that hospitals must add certain facilities to their institutions and Insta-Care was part of it.

The local hospital knocked on their door. They gave the hospital the price they believed the business was worth based on profitability, annual revenues, etc. The hospital gasped. That was way out of what they thought the price would be. The founders/doctors shrugged their shoulders again and returned to business as usual. Six months later the hospital returned and bought the business for the price they wanted. They stayed 5 years which is much longer than the norm for vesting but the hospital made it well worth their while to stay. They also loved what they were doing and essentially ran the business separate from the hospital.

After 5 years the hospital took over and asked my doctor if he would continue to stay on and work HR for the units. He knew that the hospital would not pay the workers what his partners did and they would not treat them in the way that they were used to and more than probably run on less capital with less people so he left. Unfortunate but hospitals have totally different ways of running which is why the bridge of the Insta-Care type facilities have been so successful.

He passed on the HR opportunity and left, moved to Park City with his wife, and took a job at the facility I went to for my finger. He said the first two years were extremely hard because he wanted to fix everything in the system yet he held back putting his entrepreneurial instincts in check, working 3 days a week and enjoying his next stage of life instead.

I so loved his story. Entrepreneurs are in every field and as a doctor, he saw a void and filled it. We are seeing more of these such as Ask Tia, who was on the podcast this week. The medical world is going to look significantly different in the next decade and these type of facilities will continue to grow as they fill a void in the market of patient care.

Comments (Archived):

  1. Bryce T.

    Not sure if it’s the same facility (Kimball Junction), but being the paranoid parent of a 5 year old, we’ve taken him there a number of times. Super convenient.

    1. Gotham Gal

      We went to the other one but they are all so good

  2. Susan Rubinsky

    I love these facilities. I’ve been using them for years. Even for well-care.I have not had health insurance since the inception of the ACA due to the extremely high cost (that’s a whole other story but suffice it to say that insurance costs for individuals are so exorbitant here in CT that they are unaffordable. In my case, about 22% of my gross annual income, based on the lowest cost plan I looked at this past December) so I am always looking for healthcare providers who are transparent and helpful.I frequent these facilities for a lot of reasons, including:1) They have price sheets. You call up or look at their website and you can calculate the cost of your visit and also budget for care. It’s practically impossible to budget for costs when you’re on a health insurance plan because there’s no transparency about what something will cost, then you receive a big surprise in an invoice weeks or months later. Also, it’s actually more cost-effective to visit my local facility that to visit my regular GP. (Makes me wonder how much the administrative costs are due to health insurance paperwork, rules, etc.)2) They know the costs at other vendors/providers for services and products that you may need in addition to your visit. For example, the facility I’ve been frequenting for the last eight years, will send me to the pharmacy that has the lowest price for any medication they are prescribing.3) Their computer systems are typically far more advanced than at a typical physicians office. Everything is digital at the facility I go to. You signin on a computer screen which then asks you to check and update your info. Bye-bye needless manual paperwork! The system also send you emails and text messages reminding you of appointments or to schedule an appointment.4) Pop-in or emergency visits. You can just drop in for a flu shot or whatever. Easy!I totally agree about these types of facilities and other innovative thinking in health care. I’m extremely interested to see what happens with the CVS + Aetna merger. I think some really innovative things are going to come from that.

  3. Pointsandfigures

    hope you had a tetanus shot! been there done that…and you are obviously a good cook because you have sharp knives. Now, Fred’s going to have to buy a bigger ring to cover up the scar.

  4. jason wright

    If i might be so bold (and even rude) as to ask, but how much was that treatment billed at? Was it through your own insurance, or a ‘cash’ service? There’s nothing like that in the UK. We have only the NHS A&E for this sort of thing. I do remember coming off my bicycle in Munich. I cut my fingers open, but luckily there was a street festival on the go nearby with an ambulance in attendance. The back doors were wide open, and so in i jumped. A good service, and free, even for a foreigner. I’m really not sure about the US healthcare system. It seems superior for those with access. What of the rest of society? Harsh. P.S. I hate dirty fingernails. +1.

    1. Gotham Gal

      Anyone can walk in. It takes Insurance and it also takes your own cash. I had my stitches taken out last night at one. I honestly do not know what I was charged because I have an insurance card with very little co-pay. I consider myself insanely lucky to have that.

      1. jason wright

        I’ve never really understood the realities of healthcare provision in the US. Are people without insurance and enough cash out of luck if they have a problem needing immediate attention? We hear ‘stories’ in the British media about US healthcare, and i wonder sometimes if they are gov propaganda to make us believe that we have ‘the best healthcare system in the world’, which we know we don’t have. We just have to go to France to get that reality check.

        1. Gotham Gal

          There are definitely people without insurance and I could go write a book on that but each insurance policy is different. So where one person has a $5k deductible others have none.