Would we need walk-in clinics and urgent treatment centers if doctors were more accessible?

In the standard, insurance based medical world, walk-in clinics and urgent treatment centers have become the normal.  These quick access options for very basic medical care developed out of necessity for patients to be seen in a timely manner.  In the standard practice, walk-in clinics are the relief value for a clinician’s schedule that cannot accommodate an appointment for one of their patients in need.  Now, to be fair, not every medical problem that shows up in a walk-in clinic or emergency room really has an urgency to it.  Many concerns are very routine that could be addressed in the normal course of practice if there was availability in the schedule.

In our Direct Primary Care practice, we have a much lower patient panel, nearly 1/10th the size of a standard practice, which means we have much more availability in getting our patients seen in a timely manner.  We can offer same day or next business day appointments for our patients.  Additionally, some of the concerns people use a walk-in clinic for can be addressed over the phone or via email for patients and physicians who have a well established professional relationship.  Those episodes are just another chapter in the ongoing conversation they’ve been having about the patient’s overall health.

Some people aren’t ill, but they do get sick.

Given the relaxed and low stress setting of our practice style, many people have asked if they could just come in for a walk-in appointment or one time appointment if they need medical care.  They don’t feel like they need a membership but would like a trusted physician to help them through a particular hard spot.

To help accommodate this need, Dr. Hone and Dr. Smith, our DPC physicians in Maryville, both offer walk-in visits for simple, straightforward medical concerns.  This is done a fee-for-service basis with some of the lowest rates in the area.  If a problem requires multiple visits or follow up then additional charges would be incurred.   Patients with an ongoing need for medical care such as needing refills for chronic medical concerns will be asked to join the DPC program.  It is a cost savings to the patient and allows patients to contact the physician outside of the context of an office visit.

Dr. McColl at the Hardin Valley office offers a different approach for one time visits.  He encourages patients who only want a single visit to sign up for the membership program.  The registration fee of $125 is much less than the rate of any local urgent treatment center.  As a DPC member, patients then have access to all the standard benefits including many in-office and laboratory testing at no additional charge, phone and email access during the business day, 24/7 after-hours coverage through the on-call doctor system, and follow up appointments with no per visit fees while a member.  Patients who cancel the membership within fourteen days of the visit would not owe any additional membership charges.  Once patients experience the difference in the level of care and conversation in a Direct Primary Care program, they find it hard to go back to the standard impersonal style of care.