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Urgent Care Growing Pains

So many urgent cares have popped up during the pandemic. A group of physicians open one urgent care and see it succeed, so they open another, and another. With this growth comes the urgent care growing pains.

A large medical group like Kaiser already has the workflows to run most clinics the same way. However, a smaller and newly minted urgent care group will not address this early on, which creates a lot of friction down the road.

This article will address what it takes to prevent a mass exodus of physicians and staff. Urgent cares are profitable, but onboarding physicians is expensive, and it’s easy for a few bad online reviews to ruin your revenue.

Urgent Care Expansion

If I own one urgent care, it’s not that hard to open another. At first, the same clinic manager will run both. Soon, I’ll promote one of the lead MAs to the nurse manager of the clinic. Rinse and repeat.

Hiring physicians is also relatively painless in the beginning. The volume isn’t too high in a new practice, so physician retention takes care of itself.

By the third or fifth urgent care, there are multiple physician issues to address. Each doctor has their practice style, but the urgent care needs a cohesive theme to rank well on search engines and maintain a good online profile.

Physician Practice Styles

Physicians each practice a unique style, especially if hired to fill in a space without oversight. Retraining these physicians won’t happen overnight. But fortunately, significant changes can occur with only a few essential steps.

I like to chat my patients up and have a good sense of humor, but I quickly get frazzled with angry patients. Another doctor will chastize teenage patients or perhaps be a little dismissive of the elderly.

In the end, all physicians can practice a similar style, as in, they can all get on the same page. But this requires a delicate touch and some leadership.

Physician Leadership Helping Growth

As the urgent care grows, whether, with more providers at the same location or annexing other sites, there should be a voice that the clinicians can trust.

As physicians, we don’t like being told what to do, especially when this message changes all the time. And if you don’t give us an explanation, then expect us to push back.

This physician leader should have adequate administrative time but doesn’t necessarily need to be on the front lines seeing patients. They should be available to chat with the clinical staff and send out helpful information.

Supporting the Clinical Staff

A growing urgent care will offer new services, bring on new management, build-out more rooms, and perhaps bring on imaging on-site. That’s a lot of changes that your physician or clinical staff will have to witness without feeling in control.

We’re a fickle bunch, us physicians. With our ever-dwindling autonomy, it’s nice to feel like we have some control somewhere. If our workflow constantly changes, we’ll check out mentally, then emotionally, and eventually, we’ll leave or act out.

A growing urgent care should understand that the top priority is the physician. It should be conveyed that the organization has 100% full trust in the clinical capabilities of the clinicians. But there is a certain panache to the delivery of care that they want to convey to the patient.

This latter part needs to be explained and is a skill your physician leader should have. This medical director or physician lead should convey this in a lighthearted and nonjudgmental manner.

Ensuring Flexbility

I don’t want to practice like another doctor, but I also appreciate that a new urgent care setting requires a different practice style. I want to provide the kind of care that’s culturally appropriate. This fact isn’t lost on me.

But oftentimes, I don’t know what I should be doing – what am I doing well, what am I doing wrong? Most importantly, what behavioral changes would help me get there?

I prefer not to be a robot; practicing my style with some tweaks should make me and my medical group happy. Giving me some guidance and continuous feedback can help.

Creating Workflows, Best Practices

If you’re going to have me report to another doctor, then this clinician should have some best-practices guidelines I can follow. And if these are written out, even better.

Everything from managing a UTI to an angry patient can have simple guidelines. Not complicated guidelines but facts that a physician can reference online so that there is no confusion.

Even better, build these workflows into the EMR or link to it and have it be searchable.

Should I call back patients with normal lab results? What do I do with messages left for me by the pharmacy? Can my MA call back patients? Is it okay to see a patient for free for follow-up if we messed something up on their previous visits?

Offloading Work

A growing urgent care offers more services to patients and expands its hours. This drives up profits but requires the hiring of more staff or new workflows.

It’s common that many of these things fall on the shoulders of clinicians without knowing it. This is a big mistake which should be avoided.

Any change that takes place in an expanding urgent care business should first be handled by those with less responsibility. This can be an MA, the clinic manager, or front office staff.

When work has to be added to a clinician ideally remove something else or even offer a financial incentive.

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