Urgent Care for Fast Relief

Waiting is the hardest part.

Expert Witness
By Kate Nolan

The style of American healthcare is changing. A recent phenomenon, urgent care centers provide “care on demand” for medical issues that are time-sensitive but don’t require an emergency room. NextCare Urgent Care of Mesa is a national leader in the field, with clinics in six states. We asked its founder, Dr. John Shufeldt, a St. Joseph’s Hospital emergency physician and lawyer who also holds an MBA, to describe how urgent care fits into the medical scene.

As an emergency doctor, how come you started what has become one of the country’s top urgent care providers?

I remember thinking, back in 1993, that someday someone responsible for paying medical bills, whether insurance companies or the government, is going to say, “We’re spending a lot of money for a cut on a finger or a urinary tract infection to be treated in an emergency department when the procedure wasn’t an emergency.” Someone was going to notice that and start a new way to provide care. I’ve been entrepreneurial since I was four years old, so why not me?

How does urgent care compare to emergency medicine?

I went into emergency medicine because I like taking care of critically ill patients. Urgent care is similar in that you often have to make decisions without all the facts. You don’t know the patient that well, don’t have the lab tests. You have to be a good physician because you don’t have the patient background. In a short amount of time you have to come up with a good idea of what’s wrong and hope to have a great idea of what’s not wrong. People are not good at triaging themselves. That’s why they come to the ER with colds and flu, or they come to urgent care with heart attack and stroke.

Do NextCare physicians compete with primary care 
physicians?

We operate more as an adjunct to primary care physicians. We send all our patients back to their PCPs for follow-up with a letter saying here’s what the patient experienced, here’s what we did.

A problem for Emergency Departments (or EDs) is treating a disproportionate share of uninsured patients. Do you treat the uninsured?

EDs are forced to treat the uninsured by an unfunded mandate (EMTALA, the Emergency Medical Treatment and Labor Act). We see everybody, too. If they can’t pay, we do a screening exam and make sure they have nothing life-threatening. If not, we try to work out a payment method. We also offer a subscription service, Value Care. It’s not insurance. The patient pays $50 a year and receives services at 50 percent.

What’s the deal with your WAHOO approach to the waiting room?

I’m a Seinfeld fan and there was a Seinfeld skit where Jerry says, “I hate when they make you wait in the waiting room. Because it says ‘Waiting Room,’ there’s no chance of not waiting.” I thought, why not wait at home? We came up with a fun acronym, WAHOO, which stands for Wait At Home Or Office. At home, you go on the website and put in your data. Then we call and say when your room is ready. You walk in and are treated. We keep our offices within a five- or six-mile radius of each other. If one is super busy, another one 15 minutes away may not be as busy.

Is the NextCare patient advantage primarily a cost savings?

First and foremost is convenience. It does not involve the long waits in EDs. If you are not critically ill, an ED is not the place to be. If you show up at a bad time, you can be put in that holding pattern. Our co-pays are lower than the ED. One thing I’ve noticed: People are counterintuitive. Often they come to urgent care, but don’t want to pay the $50 co-pay. They say: “I’ll go to the ER.” The co-pay is actually $150 at the ER, but the ER doesn’t make you pay right away. I wish I understood that.

To learn more, check out NextCare at nextcare.com.